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General NPI Number Information
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NPI Number | 1427215532
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Entity Type | Organization
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Legal Business Name | RACHELLE Y. EDWARDS, PH.D.
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Dates
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Enumeration Date | 05/18/2008
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Last Update Date | 05/18/2008
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Provider Practice Location Address
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Address Line | 3735 MEMORIAL DR SUITE 100
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City | DECATUR
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State | GA
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Zip | 30032-2202
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Country | US
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Telephone | 678-553-0268
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Fax |
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Provider Business Mailing Address
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Address Line | 3735 MEMORIAL DR SUITE 100
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City | DECATUR
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State | GA
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Zip | 30032-2202
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNDER
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Name | DR. RACHELLE Y EDWARDS
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Credential |
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Telephone | 678-553-0268
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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 | 2891
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License Number State | GA
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