Organization
INTOWN PSYCHOLOGICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT J LEENAN (OFFICE ADM)
(404) 474-7021
Entity
Organization
Contact information
Practice address
501 PULLIAM ST SW, STE 407, ATLANTA, GA 30312-2755
(404) 474-7021
Mailing address
501 PULLIAM ST SW, STE 407, ATLANTA, GA 30312-2755
(404) 474-7021
(404) 592-4698
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001580
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
511G701121
PTAN
GA
Enumeration date
09/03/2008
Last updated
04/02/2010
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