Healthcare Provider Details

I. General information

NPI: 1699439208
Provider Name (Legal Business Name): ISABELLA MARIA PALUMBO PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2021
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SAMARITAN DR STE 204
CUMMING GA
30040-2569
US

IV. Provider business mailing address

5305 KEITHWOOD DR
CUMMING GA
30040-5897
US

V. Phone/Fax

Practice location:
  • Phone: 470-239-0060
  • Fax:
Mailing address:
  • Phone: 239-580-8963
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY900348
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: