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General NPI Number Information
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NPI Number | 1881014801
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Entity Type | Organization
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Legal Business Name | NORTH ATLANTA NEUROPSYCHOLOGY, LLC
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 04/21/2016
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Provider Practice Location Address
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Address Line | 1134 SATELLITE BLVD NW SUITE 100A
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City | SUWANEE
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State | GA
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Zip | 30024-4370
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Country | US
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Telephone | 678-878-3559
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Fax | 678-878-3556
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Provider Business Mailing Address
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Address Line | 1134 SATELLITE BLVD NW SUITE 100A
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City | SUWANEE
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State | GA
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Zip | 30024-4370
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Country | US
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Telephone | 678-878-3559
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Fax | 678-878-3556
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Authorized Official
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Title or Position | OWNER
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Name | NORMAN LEE
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Credential | PH.D.
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Telephone | 470-297-5114
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PSY003287
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License Number State | GA
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