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General NPI Number Information
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NPI Number | 1225627599
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Entity Type | Organization
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Legal Business Name | TRUE INTEGRATIVE HEALTH CORP
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Dates
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Enumeration Date | 01/12/2021
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Last Update Date | 01/12/2021
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Provider Practice Location Address
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Address Line | 1230 PEACHTREE ST NE STE 1957
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City | ATLANTA
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State | GA
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Zip | 30309-3574
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Country | US
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Telephone | 678-322-8138
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Fax | 470-468-0134
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Provider Business Mailing Address
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Address Line | 4062 PEACHTREE RD NE STE A-536
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN OWNER
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Name | DR. DANIELLE IBELEMA
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Credential | MD
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Telephone | 678-322-8138
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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