National Provider Identifier Database

PEACHTREE PEDIATRIC PSYCHOLOGY LLC
Intellectual & Developmental Disabilities


Contact Information

PEACHTREE PEDIATRIC PSYCHOLOGY, LLC
750 HAMMOND DRIVE
BLDG 7, STE 200
ATLANTA, GA30328
Phone: 404-796-7777
Fax:
Website:
Specialty Taxonomy Code
* Intellectual & Developmental Disabilities 103TM1800X

* Indicates primary specialty

NPI Profile & details for PEACHTREE PEDIATRIC PSYCHOLOGY, LLC

NPI Number 1861998585
Legal business name
LBN
PEACHTREE PEDIATRIC PSYCHOLOGY, LLC
Authorized official AVITAL COHEN - (LICENSED PSYCHOLOGIST)
Entity Organization
Organization subpart No
Enumeration date 04/02/2018
Last updated 04/02/2018 - About 8 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 3672

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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