Individual
DR. THEODORA SOUBLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1101 BOMBAY LN, ROSWELL, GA 30076-5832
(770) 362-4815
Mailing address
1101 BOMBAY LN, ROSWELL, GA 30076-5832
(770) 362-4815
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003155
GA
Other
Enumeration date
03/03/2008
Last updated
05/27/2009
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