OrganizationActive
Fpa
NPI 1205686177 · Clinical Neuropsychologist · Dalton, GA
Provider details
- NPI number
- 1205686177
- Entity type
- Organization
- Primary specialty
- Clinical NeuropsychologistBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- David Ellis, Ceo(762) 231-5806
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Clinical Psychologist103TC0700X
Behavioral Health & Social Service Providers
- Adult Mental Health Clinic/Center261QM0850X
Ambulatory Health Care Facilities
Ambulatory Health Care Facilities
Practice location
407 N Thornton Ave Ste 4
Dalton, GA 30720-3549
Phone: (762) 231-5806
Approximate (ZIP-level) locationGet directions
Mailing address
407 N Thornton Ave Ste 4
Dalton, GA 30720-3549
Registry dates
- Enumerated
- 2024-03-25
- Last updated
- 2024-03-25
- Certified
- 2024-03-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.