MEDICARE: DR. SUSAN KATRIN PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist	PSYCH1028	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982662128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN KATRIN PH.D.

Provider Business Mailing Address
First Line	:	2801 BUFORD HWY NE
Second Line	:	SUITE 505
City	:	ATLANTA
State	:	GA
Zip	:	30329-2149
Country	:	US
Telephone Number	:	404-633-2475
Fax Number	:	404-315-9235

Provider Business Practice Location Address
First Line	:	2801 BUFORD HWY NE
Second Line	:	SUITE 505
City	:	ATLANTA
State	:	GA
Zip	:	30329-2149
Country	:	US
Telephone Number	:	404-633-2475
Fax Number	:	404-315-9235

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	07/09/2007

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Directions to “ DR. SUSAN KATRIN PH.D.” Practice Location

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