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General NPI Number Information
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NPI Number | 1962645796
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Entity Type | Organization
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Legal Business Name | PREMIER PSYCHOLOGICAL CENTER, INC.
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Dates
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Enumeration Date | 04/09/2009
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 2268 MOUNT ZION RD
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City | JONESBORO
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State | GA
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Zip | 30236-2528
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Country | US
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Telephone | 770-603-3400
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Fax | 770-603-3404
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Provider Business Mailing Address
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Address Line | 2268 MOUNT ZION RD
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City | JONESBORO
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State | GA
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Zip | 30236-2528
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Country | US
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Telephone | 770-603-3400
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Fax | 770-603-3404
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. VALERIE MCADAMS
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Credential | PSY.D
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Telephone | 770-603-3400
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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 | PSY002435
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License Number State | GA
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