Provider Demographics
NPI:1750496675
Name:PRINCE, JONI E (PHD)
Entity Type:Individual
Prefix:DR
First Name:JONI
Middle Name:E
Last Name:PRINCE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1185 HIGHTOWER TRL UNIT 500356
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31150-3106
Mailing Address - Country:US
Mailing Address - Phone:404-461-9067
Mailing Address - Fax:
Practice Address - Street 1:6065 ROSWELL RD STE 515
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4015
Practice Address - Country:US
Practice Address - Phone:404-461-9067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1723103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical