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General NPI Number Information
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NPI Number | 1619541588
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Entity Type | Organization
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Legal Business Name | SOPHRONEO PSYCHIATRY, P.C.
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Dates
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Enumeration Date | 05/16/2021
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 4170 OLD AUSTELL RD
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-2691
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Country | US
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Telephone | 470-593-8652
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Fax |
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Provider Business Mailing Address
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Address Line | 5200 DALLAS HWY STE 200-134
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-6318
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Country | US
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Telephone | 470-593-8652
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. OLAJIDE ABIODUN OPALEYE
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Credential | PMHNP
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Telephone | 470-593-8652
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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