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General NPI Number Information
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NPI Number | 1073887360
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Entity Type | Organization
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Legal Business Name | FAMILY CENTER FOR BEHAVIORAL HEALTH
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Dates
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Enumeration Date | 03/04/2012
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Last Update Date | 03/04/2012
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Provider Practice Location Address
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Address Line | 310 PROSPECT PL
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City | ALPHARETTA
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State | GA
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Zip | 30005-5467
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Country | US
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Telephone | 857-334-6348
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Fax |
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Provider Business Mailing Address
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Address Line | 703 CASWYCK TRCE
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City | ALPHARETTA
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State | GA
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Zip | 30022-4549
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Country | US
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Telephone | 857-334-6348
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ROSARIO MORILLO FALERO
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Credential | PH.D.
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Telephone | 857-334-6348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY003521
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License Number State | GA
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