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General NPI Number Information
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NPI Number | 1174149728
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Entity Type | Organization
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Legal Business Name | CHILDREN'S AUTISM ASSESSMENT CENTER
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 06/19/2020
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Provider Practice Location Address
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Address Line | 6667 VERNON WOODS DR # A-20
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-3215
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Country | US
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Telephone | 404-390-1322
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Fax | 404-835-0001
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Provider Business Mailing Address
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Address Line | 360B WINDING RIVER DR UNIT B
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City | ATLANTA
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State | GA
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Zip | 30350-1931
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Country | US
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Telephone | 478-319-6028
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST, OWNER
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Name | DR. BRANDI D SMITH
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Credential | PSY.D.
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Telephone | 478-319-6028
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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 |
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License Number State |
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