Organization
DEVELABILITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JILL WAXMAN PHD (PRESIDENT)
(770) 833-0885
Entity
Organization
Contact information
Practice address
8015 MEADOWSWEET TRCE, ROSWELL, GA 30076-3362
(770) 833-0885
Mailing address
8015 MEADOWSWEET TRCE, ROSWELL, GA 30076-3362
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Enumeration date
08/04/2021
Last updated
08/04/2021
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