Healthcare Provider Details

I. General information

NPI: 1851324842
Provider Name (Legal Business Name): PSYCHOLOGICAL TESTING & COUNSELING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 07/21/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2050 MARCONI DR SUITE 300
ALPHARETTA GA
30005-5201
US

IV. Provider business mailing address

3930 THREE CHIMNEYS LN
CUMMING GA
30041-6998
US

V. Phone/Fax

Practice location:
  • Phone: 770-777-2831
  • Fax: 770-777-2832
Mailing address:
  • Phone: 770-777-2831
  • Fax: 770-777-2832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY002613
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY002613
License Number StateGA

VIII. Authorized Official

Name: KAREN SUE SNYDER DENOIA
Title or Position: LICENSED CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 770-777-8231