Organization
FAMILIES FORWARD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARA A DELANCY PSY.D. (PSYCHOLOGIST)
(706) 210-8855
Entity
Organization
Contact information
Practice address
3711 EXECUTIVE CENTER DR, SUITE 101, MARTINEZ, GA 30907-0951
(706) 210-8855
(678) 541-7699
Mailing address
3711 EXECUTIVE CENTER DR, SUITE 101, MARTINEZ, GA 30907-0951
(706) 210-8855
(678) 541-7699
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY003096
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
447024026C
—
GA
Enumeration date
08/27/2012
Last updated
11/07/2012
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