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General NPI Number Information
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NPI Number | 1205017043
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Entity Type | Organization
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Legal Business Name | PEAK DEVELOPMENT GROUP, INC.
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 10/08/2011
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Provider Practice Location Address
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Address Line | 3300 BUCKEYE RD SUITE 307
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City | ATLANTA
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State | GA
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Zip | 30341-4229
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Country | US
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Telephone | 404-992-5125
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Fax |
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Provider Business Mailing Address
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Address Line | 3300 BUCKEYE RD SUITE 307
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City | ATLANTA
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State | GA
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Zip | 30341-4229
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Country | US
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Telephone | 404-992-5125
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ARCELLA JEAN TRIMBLE
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Credential | PH.D.
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Telephone | 404-992-5125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY003083
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License Number State | GA
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