| Center For Victims Of Torture | |
|
4020 E Ponce De Leon Ave Clarkston GA 30021-1815 | |
| (470) 545-2776 | |
| Not Available |
| Full Name | Center For Victims Of Torture |
|---|---|
| Speciality | Psychologist |
| Location | 4020 E Ponce De Leon Ave, Clarkston, Georgia |
| Authorized Official Name and Position | Ka Thao (BILLER) |
| Authorized Official Contact | 6124364860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Victims Of Torture 4020 E Ponce De Leon Ave Clarkston GA 30021-1815 Ph: (470) 545-2776 | Center For Victims Of Torture 4020 E Ponce De Leon Ave Clarkston GA 30021-1815 Ph: (470) 545-2776 |
| NPI Number | 1952253825 |
|---|---|
| Provider Enumeration Date | 02/12/2026 |
| Last Update Date | 02/12/2026 |
| Certification Date | 02/12/2026 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952253825 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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