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General NPI Number Information
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NPI Number | 1851777635
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Entity Type | Individual
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Provider Name | JEREMY SALZMAN
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Gender | Male
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 05/31/2022
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Provider Practice Location Address
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Address Line | 550 PHARR RD NE STE 605
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City | ATLANTA
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State | GA
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Zip | 30305-3469
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Country | US
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Telephone | 404-235-5982
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Fax |
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Provider Business Mailing Address
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Address Line | 550 PHARR RD SUITE 605
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City | ATLANTA
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State | GA
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Zip | 30305-8520
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Country | US
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Telephone |
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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 | PSY004140
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License Number State | GA
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