Individual
DR. LORNA L. BENBENISTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10475 MEDLOCK BRIDGE RD, SUITE 315, JOHNS CREEK, GA 30097-4433
(678) 935-9567
(678) 935-9568
Mailing address
10475 MEDLOCK BRIDGE RD, 315, JOHNS CREEK, GA 30097-4433
(678) 935-9567
(678) 935-9568
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
0001483
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00459797A
—
GA
Enumeration date
12/12/2006
Last updated
01/11/2010
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