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General NPI Number Information
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NPI Number | 1144702507
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Entity Type | Organization
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Legal Business Name | HOPE RESOURCES LLC
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Dates
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Enumeration Date | 09/02/2018
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Last Update Date | 09/25/2019
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Provider Practice Location Address
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Address Line | 814 JUNIPER ST NE STE 201
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City | ATLANTA
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State | GA
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Zip | 30308-1300
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Country | US
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Telephone | 404-965-5843
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Fax |
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Provider Business Mailing Address
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Address Line | 760 DALEROSE AVENUE
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City | DECATUR
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State | GA
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Zip | 30030
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Country | US
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Telephone | 404-965-5843
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Fax |
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Authorized Official
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Title or Position | OWNER/LICENSED PSYCHOLOGIST
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Name | DR. KATHRYN BRYAN
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Credential | PHD, MDIV
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Telephone | 404-965-5843
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number |
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License Number State |
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