Organization

Gary Santavicca, Ph.D. And Associates

Psychologist in Atlanta, GA(View on Map)

Legal Business Name

Gary Santavicca, Ph.D. And Associates

NPI Number

1518171222

NPI Type

Organization

Enumeration Date

05/10/2007

Specialties

(Taxonomies)

Code

103T00000X

Primary Taxonomy

Yes

Licenses

State

Georgia

License Number

PSY001224

Contact
Information

Purpose

Mailing
Location

Address

340 BOULEVARD NE
340 BOULEVARD NE

City

Atlanta
Atlanta

State

GA
GA

Postal Code

30312-1273
30312-1273

Country

US
US

Telephone Number

(404) 653-1117
(404) 653-1117

Authorized Official

Name

Ms. Ayanna Rule

Title or Position

INSURANCE MANAGER

Telephone Number

(404) 653-1117

Identifiers

Identifier

00423178B
00423178A

Identifier State

GA
GA

Identifier Issuer

Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2020

Provider Address

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