Healthcare Provider Details

I. General information

NPI: 1144436007
Provider Name (Legal Business Name): ABERTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4651 CHAMBLEE DUNWOODY RD SUITE D
ATLANTA GA
30338-6339
US

IV. Provider business mailing address

4651 CHAMBLEE DUNWOODY RD SUITE D
ATLANTA GA
30338-6339
US

V. Phone/Fax

Practice location:
  • Phone: 770-512-8000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MARVIN GOLDSTEIN
Title or Position: CEO
Credential:
Phone: 770-512-8000