Healthcare Provider Details

I. General information

NPI: 1528858750
Provider Name (Legal Business Name): MICHELLE HADDAD NEUROPSYCHOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 05/09/2025
Certification Date: 05/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1827 POWERS FERRY RD SE BLDG 22
ATLANTA GA
30339-5621
US

IV. Provider business mailing address

3525 PIEDMONT RD NE STE 210
ATLANTA GA
30305-1578
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-4744
  • Fax: 770-953-4640
Mailing address:
  • Phone: 404-480-3691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE M HADDAD
Title or Position: CLINICAL NEUROPSYCHOLOGIST
Credential: PHD
Phone: 404-480-3691