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General NPI Number Information
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NPI Number | 1528343407
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Entity Type | Individual
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Provider Name | CARLI HAGUE REIS PHD
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Gender | Female
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Dates
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Enumeration Date | 10/11/2011
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Last Update Date | 03/20/2012
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Provider Practice Location Address
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Address Line | 2045 PEACHTREE RD SUITE 150
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City | ATLANTA
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State | GA
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Zip | 30309
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Country | US
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Telephone | 404-403-0037
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Fax |
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Provider Business Mailing Address
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Address Line | 717 CHANNING DRIVE NW
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City | ATLANTA
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State | GA
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Zip | 30318
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Country | US
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Telephone | 678-995-5640
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY003483
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License Number State | GA
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