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General NPI Number Information
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NPI Number | 1568837391
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Entity Type | Organization
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Legal Business Name | RIVER PSYCHOTHERAPY ASSOCIATES
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Dates
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Enumeration Date | 12/04/2015
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 2570 BROOKSTONE CENTRE PKWY STE 300
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City | COLUMBUS
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State | GA
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Zip | 31904-4670
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Country | US
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Telephone | 706-322-3280
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Fax | 706-322-2272
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Provider Business Mailing Address
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Address Line | 2570 BROOKSTONE CENTRE PKWY STE 300
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City | COLUMBUS
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State | GA
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Zip | 31904-4670
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Country | US
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Telephone | 706-322-3280
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Fax | 706-322-2272
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Authorized Official
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Title or Position | OWNER
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Name | FLAVIA HARRELL
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Credential | LMFT
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Telephone | 706-322-3280
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 000288
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License Number State | GA
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