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General NPI Number Information
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NPI Number | 1679384564
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Entity Type | Organization
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Legal Business Name | THE GRACIOUS SPOT, LLC
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Dates
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Enumeration Date | 01/18/2025
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 741 PIEDMONT AVE NE
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City | ATLANTA
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State | GA
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Zip | 30308-1464
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Country | US
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Telephone | 678-242-9156
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Fax |
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Provider Business Mailing Address
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Address Line | 741 PIEDMONT AVE NE
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City | ATLANTA
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State | GA
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Zip | 30308-1464
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Country | US
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Telephone | 678-242-9156
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Fax |
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Authorized Official
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Title or Position | LICENSED PSYCHOTHERAPIST & OWNER
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Name | CHIMNEMEREM NEAL
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Credential |
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Telephone | 678-242-9156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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