Individual
KATHRYN BERTACCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 COLONIAL CENTER PKWY, ROSWELL, GA 30076-4899
(833) 351-8255
Mailing address
79 SUNDAY'S WELL RD, APT 3, CORK, CORK T23AE-93
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
89208
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
89208
GA LICENSE
GA
Enumeration date
03/31/2017
Last updated
10/09/2025
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