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General NPI Number Information
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NPI Number | 1346499209
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Entity Type | Organization
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Legal Business Name | ATLANTA INSOMNIA AND BEHAVIORAL HEALTH SERVICES, P.C.
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Dates
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Enumeration Date | 09/16/2008
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 315 W PONCE DE LEON AVE SUITE 1051
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City | DECATUR
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State | GA
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Zip | 30030-2400
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Country | US
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Telephone | 404-378-0441
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Fax |
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Provider Business Mailing Address
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Address Line | 315 W PONCE DE LEON AVE SUITE 1051
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City | DECATUR
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State | GA
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Zip | 30030-2400
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Country | US
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Telephone | 404-378-0441
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | DR. ANNE BARTOLUCCI
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Credential | PH.D.
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Telephone | 404-702-9158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY003003
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License Number State | GA
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