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General NPI Number Information
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NPI Number | 1033795059
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Entity Type | Individual
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Provider Name | FELICIA PRATHER MD
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Gender | Female
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Dates
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Enumeration Date | 03/21/2021
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Last Update Date | 03/21/2021
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Provider Practice Location Address
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Address Line | 962 JOSEPH E BOONE BLVD NW # 13
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City | ATLANTA
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State | GA
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Zip | 30314-2765
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Country | US
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Telephone | 678-881-7695
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Fax |
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Provider Business Mailing Address
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Address Line | 962 JOSEPH E BOONE BLVD NW
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City | ATLANTA
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State | GA
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Zip | 30314-2765
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Country | US
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Telephone | 678-881-7695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number |
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 207QA0401X
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Taxonomy Name | Addiction Medicine (Family Medicine) Physician
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License Number | 1167203
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License Number State | GA
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Taxonomy #8
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Taxonomy Code | 103TP0016X
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Taxonomy Name | Prescribing (Medical) Psychologist
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License Number |
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License Number State |
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