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General NPI Number Information
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NPI Number | 1184883613
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Entity Type | Organization
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Legal Business Name | STEPHANIE H. PERLEBERG, PH.D., P.C.
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Dates
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Enumeration Date | 06/09/2008
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Last Update Date | 06/09/2008
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Provider Practice Location Address
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Address Line | 3534 OLD MILTON PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4459
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Country | US
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Telephone | 678-624-0310
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Fax | 678-624-0258
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Provider Business Mailing Address
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Address Line | 3534 OLD MILTON PKWY
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City | ALPHARETTA
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State | GA
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Zip | 30005-4459
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Country | US
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Telephone | 678-624-0310
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Fax | 678-624-0258
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. STEPHANIE H. PERLEBERG
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Credential | PH.D.
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Telephone | 678-624-0310
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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 | 2440
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License Number State | GA
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