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General NPI Number Information
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NPI Number | 1831504349
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Entity Type | Organization
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Legal Business Name | INSTITUTE FOR CLARITY
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 06/23/2014
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Provider Practice Location Address
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Address Line | 11205 ALPHARETTA HIGHWAY SUITE A5
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City | ROSWELL
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State | GA
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Zip | 30076
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Country | US
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Telephone | 770-667-8992
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Fax | 770-667-8992
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Provider Business Mailing Address
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Address Line | 11205 ALPHARETTA HIGHWAY SUITE A5
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City | ROSWELL
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State | GA
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Zip | 30076
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Country | US
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Telephone | 770-667-8992
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Fax | 770-667-8992
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | PATI BEAUDOIN
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Credential |
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Telephone | 770-667-8992
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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 | PSY001816
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License Number State | GA
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