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General NPI Number Information
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NPI Number | 1497121008
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Entity Type | Individual
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Provider Name | JOHN DAVID VANEATON MA, APC
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Gender | Male
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Dates
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Enumeration Date | 08/18/2015
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Last Update Date | 08/18/2015
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Provider Practice Location Address
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Address Line | 1640 POWERS FERRY RD SE BUILDING 16 STE 100
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City | MARIETTA
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State | GA
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Zip | 30067-5491
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Country | US
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Telephone | 678-995-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 781 HOLMES ST NW
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City | ATLANTA
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State | GA
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Zip | 30318-7623
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Country | US
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Telephone | 678-641-4026
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC003786
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License Number State | GA
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