Provider Demographics
NPI:1871764282
Name:PATHWAYS UNLIMITED, INC
Entity type:Organization
Organization Name:PATHWAYS UNLIMITED, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MONIQUE
Authorized Official - Middle Name:FARR
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-413-1980
Mailing Address - Street 1:913 MAIN ST STE H
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30083-3096
Mailing Address - Country:US
Mailing Address - Phone:770-413-1980
Mailing Address - Fax:770-413-8118
Practice Address - Street 1:913 MAIN ST STE H
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3096
Practice Address - Country:US
Practice Address - Phone:770-413-1980
Practice Address - Fax:770-413-8118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-13
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2373103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty