Provider Demographics
NPI:1306272299
Name:PERFORMANCE DEVELOPMENT INCORPORATED
Entity type:Organization
Organization Name:PERFORMANCE DEVELOPMENT INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:HIGDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-595-2244
Mailing Address - Street 1:6030 CHINA ROSE LN
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8485
Mailing Address - Country:US
Mailing Address - Phone:678-595-2244
Mailing Address - Fax:
Practice Address - Street 1:4501 CIRCLE 75 PKWY SE
Practice Address - Street 2:SUITE 5220 BUILDING E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-3025
Practice Address - Country:US
Practice Address - Phone:678-595-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-24
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002599103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty