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Gwendolyn Moddrell Md Pc
Prescribing (Medical) Psychologist in Swainsboro, Georgia
NPI 1992911234

Gwendolyn Moddrell Md Pc is a Prescribing (Medical) Psychologist based in Swainsboro, GA and is specialized in Prescribing (Medical). Gwendolyn Moddrell Md Pc practices in Swainsboro, GA. The NPI Number for Gwendolyn Moddrell Md Pc is 1992911234 and holds a License No. (Georgia).

The current practice location address for Gwendolyn Moddrell Md Pc is 247 W Main St # B, Swainsboro, GA and can be reached out via phone at 478-237-8101 and via fax at 478-237-8118.

Location: 247 W Main St # B, Swainsboro, GA, 30401-3163
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1992911234
Provider Name
Gwendolyn Moddrell Md Pc
Credential
Provider Entity Type
Organization
Address
247 W Main St # B, Swainsboro, GA, 30401-3163
Phone Number
478-237-8101
Fax Number
478-237-8118
Provider Enumeration Date
05/15/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
247 W Main St # B
City
Swainsboro
State
Georgia
Zip
30401-3163
Phone Number
478-237-8101
Fax Number
478-237-8118
person
Provider Business Mailing Address Details
Address
247 W Main St # B
City
Swainsboro
State
Georgia
Zip
30401-3163
Phone Number
478-237-8101
Fax Number
478-237-8118
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Prescribing (Medical)
Taxonomy
103TP0016X
License No.
()
Definition
A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
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