Healthcare Provider Details

I. General information

NPI: 1942074737
Provider Name (Legal Business Name): SALLY MANYOR ARREY PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 07/05/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 SEAGRAVES DR STE 3
ATHENS GA
30605-2492
US

IV. Provider business mailing address

4133 VILLAGE PRESERVE WAY
GAINESVILLE GA
30507-3321
US

V. Phone/Fax

Practice location:
  • Phone: 470-295-2697
  • Fax: 170-622-8964
Mailing address:
  • Phone: 470-295-2697
  • Fax: 706-229-8964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN317205
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberNP317205
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: