DR. NICK A DEFILIPPIS PH.D.
Clinical Neuropsychologist
Atlanta, Georgia
Provider NPI: 1295798486
Provider Information:DR. NICK A DEFILIPPIS PH.D.
Gender: M
Sole Proprietor
Practice Location:
990 HAMMOND DR NE SUITE 730 ATLANTA, GA 30328 US
Tel: 770-730-9930 Fax: 770-730-0998
Business Mailing Address:
990 HAMMOND DR STE 575 ATLANTA, GA 30328 US
Tel: 770-730-9930 Fax: 770-730-0998
Entity Type: Individual
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | GA | 536 |
N | 103TA0400X | Behavioral Health & Social Service Providers Psychologist | GA | 536 |
Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | GA | 536 |
N | 103TF0200X | Behavioral Health & Social Service Providers Psychologist | GA | 536 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
00136309C | GA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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