MEDICARE: DAILY DBT LLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY003475	GA

General Provider Information

NPI Number	:	1528460870
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAILY DBT LLP

Provider Business Mailing Address
First Line	:	1409 N HIGHLAND AVE NE STE J
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3300
Country	:	US
Telephone Number	:	404-550-5879
Fax Number	:

Provider Business Practice Location Address
First Line	:	1409 N HIGHLAND AVE NE STE J
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30306-3300
Country	:	US
Telephone Number	:	404-550-5879
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. LAUREN EDWARDS
Credential	:	PHD
Telephone Number	:	404-550-5879

Provider Enumeration Date	:	09/18/2014
Last Update Date	:	09/18/2014

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