Individual
LISELOTTE DE WIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1441 CLIFTON RD NE, ATLANTA, GA 30322-1004
(404) 712-5667
Mailing address
1135 ARLINGTON PKWY NE, ATLANTA, GA 30324-4506
(786) 338-0735
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PSY004717
GA
Other
Enumeration date
06/13/2024
Last updated
03/25/2025
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