Healthcare Provider Details

I. General information

NPI: 1093342354
Provider Name (Legal Business Name): GEETA AATRE PSYCHOLOGICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 01/25/2024
Certification Date: 01/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2450 ATLANTA HWY STE 202
CUMMING GA
30040-1251
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 470-326-7332
  • Fax: 770-953-4640
Mailing address:
  • Phone: 770-953-4744
  • Fax: 770-953-4640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. GEETA P AATRE
Title or Position: CEO
Credential: PSYD
Phone: 832-228-2460