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Individual

DR. LAURA M. RISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
3650 STEVE REYNOLDS BLVD, KAISER PERMANENTE GWINNETT MEDICAL CENTER, DULUTH, GA 30096-4506
(770) 931-6063
(706) 850-0899
Mailing address
3495 PIEDMONT RD NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305-1717
(404) 364-7070
(706) 850-0899

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
PSY 002955
GA
103T00000X
Psychologist
Primary
PSY002955
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
140137175B
GA
Enumeration date
11/20/2006
Last updated
01/07/2022
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