Provider Demographics
NPI:1538339379
Name:SPEARS, DANA SCOTT (PHD)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:SCOTT
Last Name:SPEARS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DANA
Other - Middle Name:K
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 HABERSHAM DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214
Mailing Address - Country:US
Mailing Address - Phone:770-461-9944
Mailing Address - Fax:770-461-9779
Practice Address - Street 1:115 HABERSHAM DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-461-9944
Practice Address - Fax:770-461-9779
Is Sole Proprietor?:No
Enumeration Date:2008-03-07
Last Update Date:2008-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC00236101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional