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Contact Information

COMMENCEMENT ETC PC
1300 RIDENOUR BLVD NW STE 100
KENNESAW, GA30152-4528
 Phone: 470-407-3127
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Forensic

103TF0200X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
 

Health

103TH0004X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for COMMENCEMENT ETC PC · (Female)

NPI # 1215649967
Status Active
Credentials
Entity Individual
Enumeration date 12/14/2022
Last updated 12/14/2022 - About 3 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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