Provider Demographics
NPI:1184749103
Name:FRANCO, GRACELYN CLAIRE (PHD)
Entity type:Individual
Prefix:
First Name:GRACELYN
Middle Name:CLAIRE
Last Name:FRANCO
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 1:1121 ALDERMAN DR
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-5463
Mailing Address - Country:US
Mailing Address - Phone:770-205-4292
Mailing Address - Fax:
Practice Address - Street 1:1121 ALDERMAN DR
Practice Address - Street 2:SUITE 106
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-5463
Practice Address - Country:US
Practice Address - Phone:770-205-4292
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA722103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical