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General NPI Number Information
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NPI Number | 1568865830
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Entity Type | Organization
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Legal Business Name | KIMBERLY SMILEY, PSY.D., LLC
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 1827 POWERS FERRY ROAD, BUILDING 22
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City | ATLANTA
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State | GA
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Zip | 30339
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Country | US
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Telephone | 770-953-4744
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Fax | 770-953-4640
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Provider Business Mailing Address
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Address Line | 1827 POWERS FERRY ROAD, BUILDING 22
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City | ATLANTA
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State | GA
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Zip | 30339
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Country | US
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Telephone | 770-953-4744
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Fax | 770-953-4640
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | KIMBERLY SMILEY
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Credential | PSY.D.
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Telephone | 770-953-4744
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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 | PSY002828
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License Number State | GA
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