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General NPI Number Information
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NPI Number | 1235684382
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Entity Type | Individual
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Provider Name | BRANDI D SMITH PSYD
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Gender | Female
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 07/29/2020
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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 | ATLANTA
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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 |
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Provider Business Mailing Address
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Address Line | 360 WINDING RIVER DR UNIT B
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City | ATLANTA
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State | GA
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Zip | 30350-1937
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Country | US
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Telephone | 44-390-1322
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY004223
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License Number State | GA
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