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General NPI Number Information
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NPI Number | 1639805096
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Entity Type | Individual
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Provider Name | ANDREA BURGIO-MURPHY PHD
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Gender | Female
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 07/28/2022
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Provider Practice Location Address
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Address Line | 2878 JOHNSON FERRY RD STE 200
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City | MARIETTA
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State | GA
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Zip | 30062-8308
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Country | US
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Telephone | 770-377-2462
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Fax |
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Provider Business Mailing Address
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Address Line | 4632 CLARY LAKES DR NE
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City | ROSWELL
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State | GA
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Zip | 30075-5447
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Country | US
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Telephone | 770-377-2462
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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 | PSY003242
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License Number State | GA
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