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General NPI Number Information
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NPI Number | 1821697475
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Entity Type | Organization
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Legal Business Name | MOSHE MANHEIM, LCSW
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 6740 JAMESTOWN DR.
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City | ALPHARETTA
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State | GA
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Zip | 30005
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Country | US
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Telephone | 678-469-3631
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Fax | 678-339-1221
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Provider Business Mailing Address
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Address Line | 6740 JAMESTOWN DR.
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City | ALPHARETTA
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State | GA
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Zip | 30005
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Country | US
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Telephone | 678-469-3631
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Fax | 678-339-1221
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | MOSHE MANHEIM
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Credential | LCSW
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Telephone | 678-469-3631
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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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