Healthcare Provider Details

I. General information

NPI: 1710085949
Provider Name (Legal Business Name): THE RIVER PSYCHOTHERAPY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 RIVER RD SUITE 301
COLUMBUS GA
31904-4578
US

IV. Provider business mailing address

5900 RIVER RD SUITE 301
COLUMBUS GA
31904-4578
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-3280
  • Fax:
Mailing address:
  • Phone: 706-322-3280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: JUDY R GARRETT
Title or Position: CODER
Credential:
Phone: 706-322-3280