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General NPI Number Information
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NPI Number | 1396965109
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Entity Type | Organization
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Legal Business Name | ZEPHYR MEADOWS, PC
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 170 WHITNEY ST
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2012
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Country | US
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Telephone | 770-843-9026
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Fax | 678-817-0738
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Provider Business Mailing Address
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Address Line | 170 WHITNEY ST
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-2012
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Country | US
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Telephone | 770-843-9026
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Fax | 678-817-0738
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Authorized Official
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Title or Position | CHIEF PSYCHOLOGIST
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Name | DR. WENDY BAILEY
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Credential | PH.D.
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Telephone | 770-843-9026
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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 | PSY002609
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License Number State | GA
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