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Organization

NEUROSMART PSYCHOLOGICAL ASSOCIATES, P.C.

Active
Other names
NeuroSmart, Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KATHRYN C BLACK PH.D. (PRESIDENT)
(770) 889-2848
Entity
Organization

Contact information

Practice address
309 PIRKLE FERRY RD, SUITE A-200, CUMMING, GA 30040-2546
(770) 889-2848
Mailing address
309 PIRKLE FERRY RD, SUITE A-200, CUMMING, GA 30040-2546
(770) 889-2848

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
GA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
614308690A
GA
Enumeration date
04/02/2007
Last updated
04/14/2011
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