Provider Demographics
NPI:1033965454
Name:PALANISAMY, SATHIYA PRIYA
Entity Type:Individual
Prefix:
First Name:SATHIYA PRIYA
Middle Name:
Last Name:PALANISAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 CALEDONIA CT
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-2314
Mailing Address - Country:US
Mailing Address - Phone:404-977-6712
Mailing Address - Fax:
Practice Address - Street 1:6000 SHAKERAG HL STE 314
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-6523
Practice Address - Country:US
Practice Address - Phone:404-977-6712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health