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DR. CHARLES DUDLEIGH HACKETT PH.D.

>> Marriage & Family Therapist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1194211631

Individual Registrant:
DR. CHARLES DUDLEIGH HACKETT PH.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
316 TEA BERRY LN.  BIG CANOE, GA 30143-3014 US
Tel: 404-375-0914  Fax: --

Contact information for business:
10298 BIG CANOE  BIG CANOE, GA 30143-5121 US
Tel: 404-731-2578  Fax: --

Registration Information:
NPI: 1194211631
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y106H00000XBehavioral Health & Social Service Providers
Marriage & Family Therapist
GAMFT000579

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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