Boudewyns, Patrick A.

Boudewyns, Patrick A. is an individual health care provider with primary practice located at 1120 15Th St , Augusta GA 30912-0004. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Boudewyns, Patrick A. can be contacted via phone (706) 721-3141.

Contact Information

Primary practice address
1120 15Th St Augusta GA 30912-0004
Phone: (706) 721-3141
Fax: (706) 721-6602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY000791 Georgia

Profile Details

NPI number 1063522779
LBN Legal business name Boudewyns, Patrick A.
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated Mar 30th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063522779 NPPES
Georgia MEDICAID 000257771A
Georgia MEDICAID PS0178

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