Healthcare Provider Details

I. General information

NPI: 1467483396
Provider Name (Legal Business Name): DARRYL LEE TOWNES PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 08/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 PEACHTREE ST SUITE 3300
ATLANTA GA
30303-1740
US

IV. Provider business mailing address

2337 DEERFIELD CHASE SE
CONYERS GA
30013-6307
US

V. Phone/Fax

Practice location:
  • Phone: 770-880-5332
  • Fax: 678-420-3488
Mailing address:
  • Phone: 770-880-5332
  • Fax: 678-420-3488

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number002894
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: