Individual
DR. ANITA BANSAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
5755 N POINT PKWY, SUITE 256, ALPHARETTA, GA 30022-1142
(770) 667-3877
(770) 667-3879
Mailing address
PO BOX 250, ALPHARETTA, GA 30009-0250
(770) 667-3877
(770) 667-3879
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002662
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685007337A
—
GA
Enumeration date
08/30/2006
Last updated
09/23/2008
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