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Individual

DR. CHARLES MOYER MENDENHALL III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH.D.

Contact information

Practice address
1814 CLAIRMONT RD, DECATUR, GA 30033-3405
(404) 636-1457
(404) 636-7449
Mailing address
320 INMAN DR, DECATUR, GA 30030-3835
(404) 377-8256
(404) 636-7449

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
MFT000948
GA

Other

Enumeration date
01/12/2007
Last updated
07/08/2007
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