Healthcare Provider Details

I. General information

NPI: 1467647040
Provider Name (Legal Business Name): DARNYL RANDI KATZINGER PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2007
Last Update Date: 09/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1778 CENTURY BLVD NE SUITE A
ATLANTA GA
30345-3398
US

IV. Provider business mailing address

1778 CENTURY BLVD NE SUITE A
ATLANTA GA
30345-3398
US

V. Phone/Fax

Practice location:
  • Phone: 404-638-6650
  • Fax: 404-638-6651
Mailing address:
  • Phone: 404-638-6650
  • Fax: 404-638-6651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License NumberPSY003100
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY003100
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY003100
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code103TH0004X
TaxonomyHealth Psychologist
License NumberPSY003100
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: