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General NPI Number Information
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NPI Number | 1558675264
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Entity Type | Organization
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Legal Business Name | PETERKIN AND ASSOCIATES, INC.
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 2692 HARRIS ST SUITE 200
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City | EAST POINT
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State | GA
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Zip | 30344-2672
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Country | US
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Telephone | 404-228-4548
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Fax | 404-228-4597
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Provider Business Mailing Address
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Address Line | 2692 HARRIS ST SUITE 200
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City | EAST POINT
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State | GA
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Zip | 30344-2672
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Country | US
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Telephone | 404-228-4548
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Fax | 404-228-4597
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Authorized Official
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Title or Position | CEO
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Name | MRS. ALICE SMITH
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Credential | ED.D
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Telephone | 404-228-4548
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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