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KATHLEEN M OTOOLE PHD

Clinical Neuropsychologist

Atlanta, Georgia

Provider NPI: 1114967759

Provider Information:
 KATHLEEN M OTOOLE PHD
Gender: F


Practice Location:
1001 JOHNSON FERRY RD NE  ATLANTA, GA 30342 US
Tel: 404-250-2849  Fax: 404-250-2939

Business Mailing Address:
1001 JOHNSON FERRY RD NE  ATLANTA, GA 30342 US
Tel: 404-785-2854  Fax: 404-785-2851

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
X103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
GA001931
X103T00000XBehavioral Health & Social Service Providers
Psychologist
GA001931

Other Provider Identifiers:

IssuerNumberStateType
00706329AGA05
Code values:
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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