Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 103TP0016X | Prescribing (Medical) | ||
N | 103TS0200X | School Psychologist | GA | |
N | 1041S0200X | School Social Worker | ||
N | 207QA0401X | Family Doctor - Addiction Medicine | 1167203 | GA |
NPI | 1033795059 |
---|---|
Provider Name | Felicia Prather |
First Address | Atlanta, GA 30314-2765 |
Second Address | Atlanta, GA 30314-2765 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2021 |
Last Update Date | 21/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
053043082 | FAMILY MEDICINE (01) | GA |