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Organization

PSYCHOTHERAPY AND ASSESSMENT SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. AMY TODD DAVIS PH. D (PRESIDENT)
(770) 534-9100
Entity
Organization

Contact information

Practice address
629 DAWSONVILLE HWY, SUITE 2201, GAINESVILLE, GA 30501-2610
(770) 534-9100
(770) 534-9104
Mailing address
629 DAWSONVILLE HWY, SUITE 2201, GAINESVILLE, GA 30501-2610
(770) 534-9100
(770) 534-9104

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1575
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00484514C
GA
Enumeration date
01/17/2007
Last updated
08/22/2020
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