Provider Demographics
NPI:1669633657
Name:DR. VALRIE M. HONABLUE, INC.
Entity type:Organization
Organization Name:DR. VALRIE M. HONABLUE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VALRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:HONABLUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-402-6076
Mailing Address - Street 1:PO BOX 421667
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-8667
Mailing Address - Country:US
Mailing Address - Phone:770-454-1252
Mailing Address - Fax:770-454-1256
Practice Address - Street 1:2150 PEACHFORD RD
Practice Address - Street 2:SUITE H
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30338-6520
Practice Address - Country:US
Practice Address - Phone:770-454-1252
Practice Address - Fax:770-454-1256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-23
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0378352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty