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General NPI Number Information
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NPI Number | 1518386408
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Entity Type | Organization
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Legal Business Name | HEALING MATTERS, LLC
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Dates
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Enumeration Date | 04/08/2014
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Last Update Date | 04/08/2014
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Provider Practice Location Address
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Address Line | 1151 SHERIDAN RD NE
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City | ATLANTA
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State | GA
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Zip | 30324-3714
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Country | US
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Telephone | 319-936-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 116 PONCE DE LEON AVE NE 2603
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City | ATLANTA
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State | GA
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Zip | 30308-4113
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Country | US
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Telephone | 319-936-4090
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. ELHAM BAGHERI
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Credential | PHD
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Telephone | 319-936-4090
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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 | PSY003760
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License Number State | GA
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