Individual
EDITH FRESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1513 EAST CLEVELAND AVE BLGD 500, EAST POINT, GA 30344-6903
(404) 752-1000
(404) 752-1191
Mailing address
75 PIEDMONT AVE, STE 700, ATLANTA, GA 30303
(404) 756-1400
(404) 756-1400
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY1863
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00612763A
—
GA
Enumeration date
08/30/2006
Last updated
10/25/2013
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