Organization
MINDBRAIN INSTITUTE OF ATLANTA
Active
Other names
MindBrain Institute of Atlanta
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA HOLBERG GORDICK PHD (OWNER/CLINICAL DIRECTOR)
(404) 692-7027
Entity
Organization
Contact information
Practice address
2200 CENTURY PKWY NE STE 200, ATLANTA, GA 30345-3103
(404) 692-7027
Mailing address
2200 CENTURY PKWY NE STE 200, ATLANTA, GA 30345-3103
(404) 692-7027
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356672331
NPI 1
—
Enumeration date
11/09/2019
Last updated
11/09/2019
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