Provider Demographics
NPI:1497902480
Name:DEBRA ALVIS, PH.D., INC
Entity Type:Organization
Organization Name:DEBRA ALVIS, PH.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:ALVIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:706-369-7441
Mailing Address - Street 1:1551 JENNINGS MILL RD
Mailing Address - Street 2:SUITE 2000 B
Mailing Address - City:BOGART
Mailing Address - State:GA
Mailing Address - Zip Code:30622-2544
Mailing Address - Country:US
Mailing Address - Phone:706-369-7441
Mailing Address - Fax:706-549-2569
Practice Address - Street 1:1551 JENNINGS MILL RD
Practice Address - Street 2:SUITE 2000 B
Practice Address - City:BOGART
Practice Address - State:GA
Practice Address - Zip Code:30622-2544
Practice Address - Country:US
Practice Address - Phone:706-369-7441
Practice Address - Fax:706-549-2569
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY2296251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health