Provider Demographics
NPI:1043218993
Name:COHEN, NEAL A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:A
Last Name:COHEN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:NEAL
Other - Middle Name:
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:300 COLONIAL CENTER PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4899
Mailing Address - Country:US
Mailing Address - Phone:678-353-3277
Mailing Address - Fax:678-353-3211
Practice Address - Street 1:300 COLONIAL CENTER PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4899
Practice Address - Country:US
Practice Address - Phone:678-353-3277
Practice Address - Fax:678-353-3211
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002847103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical