Flying Change
Specialty details in registry · Atlanta, GA
At a glance
4680 Polo Ln Se, Atlanta, GA 30339-5346
NPPES record updated Dec 30, 2010. Public records can lag behind changes at a practice.
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- Are you accepting new patients?
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Insurance participation and appointment availability are not established by these public records.
Practice location
4680 Polo Ln SeAtlanta, GA 30339-5346
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 101Y00000X
- Enumeration date
- Dec 30, 2010
- Record updated
- Dec 30, 2010
More registry details
- Provider type
- Organization · Type 2
Reported taxonomies and licenses
Specialty details in registry
101Y00000X · Primary
Psychologist
103T00000X
Specialty details in registry
104100000X
Specialty details in registry
106H00000X
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
4680 Polo Ln SeAtlanta, GA 30339-5346
- Phone
- (404) 512-0834
- Fax
- (770) 832-3969
Mailing address
4680 POLO LN SEATLANTA, GA 303395346
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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