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General NPI Number Information
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NPI Number | 1104046366
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Entity Type | Organization
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Legal Business Name | DOUGLAS E WEBB JR PHD INC
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2453 NORTH DECATUR ROAD
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City | DECATUR
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State | GA
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Zip | 30033
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Country | US
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Telephone | 404-257-2722
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Fax |
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Provider Business Mailing Address
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Address Line | 685 DENSLEY DRIVE
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City | DECATUR
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State | GA
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Zip | 30033-5445
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Country | US
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Telephone | 404-257-2722
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Fax | 404-320-9510
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Authorized Official
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Title or Position | CORPORATION PRESIDENT
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Name | MR. DOUGLAS E WEBB JR.
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Credential | PHD
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Telephone | 404-257-2722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1600
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License Number State | GA
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