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General NPI Number Information
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NPI Number | 1376810655
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Entity Type | Organization
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Legal Business Name | SMH ASSOCIATES
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Dates
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Enumeration Date | 11/30/2011
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Last Update Date | 11/30/2011
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Provider Practice Location Address
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Address Line | 675 SEMINOLE AVE NE STE 307
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City | ATLANTA
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State | GA
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Zip | 30307-3416
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Country | US
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Telephone | 650-704-9683
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Fax |
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Provider Business Mailing Address
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Address Line | 675 SEMINOLE AVE NE STE 307
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City | ATLANTA
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State | GA
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Zip | 30307-3416
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Country | US
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Telephone | 650-704-9683
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | SOLEDAD HAMMOND
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Credential | PSY.D.
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Telephone | 650-704-9683
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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 | PSY003439
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License Number State | GA
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