Organization
PROMEDICA, INC.
Active
Other names
PROMEDICA PSYCHIATRY GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KIMBERLY H. LITTRELL MS, APRN, BC (PRESIDENT & CEO)
(770) 554-8812
Entity
Organization
Contact information
Practice address
2430 TUCKER DR, BLDG A, LOGANVILLE, GA 30052-4390
(770) 554-8812
(770) 554-9810
Mailing address
2430 TUCKER DR, BLDG A, LOGANVILLE, GA 30052-4390
(770) 554-8812
(770) 554-9810
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
029689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00345408A
—
GA
Enumeration date
06/30/2006
Last updated
04/28/2008
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