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Individual

DR. MARK FRANKLIN BRECHTEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1 HUNTINGTON RD, STE 103, ATHENS, GA 30606-7204
(706) 369-0970
Mailing address
428 SAWDUST TRL, NICHOLSON, GA 30565-3097
(706) 372-6199

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002805
GA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TC0700X
Clinical Psychologist
PSY002805
GA
103TC1900X
Counseling Psychologist
103TF0000X
Family Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1162893
CAQH
GA
05
750409758A
GA
Enumeration date
08/22/2006
Last updated
07/05/2009
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