Organization
CARREFOUR OF ATLANTA PSYCHOLOGICAL HEALTH INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYDIA ODENAT PHD (LICENSED PSYCHOLOGIST)
(678) 687-9149
Entity
Organization
Contact information
Practice address
2751 BUFORD HWY NE STE 700, ATLANTA, GA 30324-3207
(678) 687-9149
Mailing address
2465 MAIN ST UNIT 307, EAST POINT, GA 30344-2675
(678) 687-9149
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003854
GA
Other
Enumeration date
01/23/2015
Last updated
01/23/2015
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