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General NPI Number Information
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NPI Number | 1972710762
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Entity Type | Organization
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Legal Business Name | MARTIN L. FLEET, PH.D.
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1827 POWERS FERRY RD SE BUILDING 22, SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30339-5621
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Country | US
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Telephone | 770-953-4744
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Fax | 770-953-4640
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Provider Business Mailing Address
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Address Line | 1827 POWERS FERRY RD SE BUILDING 22, SUITE 200
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City | ATLANTA
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State | GA
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Zip | 30339-5621
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Country | US
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Telephone | 770-953-4744
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Fax | 770-953-4640
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARTIN L. FLEET
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Credential | PH.D.
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Telephone | 770-953-4744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | 001154
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License Number State | GA
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