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General NPI Number Information
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NPI Number | 1508228867
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Entity Type | Organization
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Legal Business Name | TALK WORKS INC
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 3001 MONROE HWY STE 600 C
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City | BOGART
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State | GA
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Zip | 30622-8513
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Country | US
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Telephone | 706-224-0012
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Fax |
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Provider Business Mailing Address
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Address Line | 3001 MONROE HWY STE 600 C
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City | BOGART
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State | GA
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Zip | 30622-8513
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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 | CEO
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Name | MARIE WILLIAMS
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Credential | PHD
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Telephone | 706-224-0012
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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 | PSY003172
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License Number State | GA
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