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Individual

DR. GARY FRANCIS GANAHL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1770 CENTURY BLVD NE STE B, SUITE B, ATLANTA, GA 30345-3395
(404) 329-9977
(404) 329-0583
Mailing address
1770 CENTURY BLVD NE STE B, SUITE B, ATLANTA, GA 30345-3395
(404) 329-9977
(404) 329-0583

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001192
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000574604G
GA
Enumeration date
01/01/2007
Last updated
07/09/2007
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