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General NPI Number Information
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NPI Number | 1710709886
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Entity Type | Organization
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Legal Business Name | REACH HIGHER PSYCHOLOGICAL SERVICES LLC
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Dates
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Enumeration Date | 10/29/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 1027 BRIDGEGATE CT NE
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City | MARIETTA
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State | GA
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Zip | 30068-2201
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Country | US
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Telephone | 412-716-2345
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Fax |
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Provider Business Mailing Address
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Address Line | 1027 BRIDGEGATE CT NE
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City | MARIETTA
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State | GA
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Zip | 30068-2201
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Country | US
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Telephone | 412-716-2345
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADDAM JOSEPH WAWRZONEK
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Credential | PHD
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Telephone | 412-716-2345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number |
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License Number State |
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