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Contact Information

DEPARTMENT OF BEHAVIORAL HEALTH & DEVELOPMENTAL DISABILITIES, GA
400 S PINETREE BLVD
THOMASVILLE, GA31792-7128
 Phone: 229-227-2990
 Fax: 229-225-4052
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurology

2084N0400X 13 Physician/Neurology
 

General Practice

208D00000X 99 Physician/Undefined Physician type[6]
Indicates primary specialty

NPI Profile & details for DEPARTMENT OF BEHAVIORAL HEALTH DEVELOPMENTAL DISABILITIES GA · (Female)

NPI Number 1174942684
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2014
Last updated 04/11/2014 - About 12 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 30647
  • GA License # 51452
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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