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General NPI Number Information
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NPI Number | 1831215607
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Entity Type | Organization
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Legal Business Name | NORTHWEST GEORGIA PSYCHOLOGICAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 215 BROAD ST SUITE 201
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City | ROME
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State | GA
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Zip | 30161-1708
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Country | US
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Telephone | 706-295-2498
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Fax | 706-295-5666
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Provider Business Mailing Address
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Address Line | 215 BROAD ST SUITE 201
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City | ROME
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State | GA
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Zip | 30161-1708
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Country | US
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Telephone | 706-295-2498
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Fax | 706-295-5666
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. D'ANN DOWNEY
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Credential | PH.D.
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Telephone | 706-295-2498
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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 | 2642
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License Number State | GA
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