Provider Demographics
NPI:1801997374
Name:BUTTERFIELD, PATRICE H (PHD)
Entity type:Individual
Prefix:DR
First Name:PATRICE
Middle Name:H
Last Name:BUTTERFIELD
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 1:315 COMMERCIAL DR
Mailing Address - Street 2:SUITE A-1
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3628
Mailing Address - Country:US
Mailing Address - Phone:912-691-0001
Mailing Address - Fax:912-691-2838
Practice Address - Street 1:315 COMMERCIAL DR
Practice Address - Street 2:SUITE A-1
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3628
Practice Address - Country:US
Practice Address - Phone:912-691-0001
Practice Address - Fax:912-691-2838
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1026103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00631177CMedicaid
GA00631177CMedicaid