Provider Demographics
NPI:1205041100
Name:MIRSALIMI, HAMID (PHD)
Entity Type:Individual
Prefix:DR
First Name:HAMID
Middle Name:
Last Name:MIRSALIMI
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 NORCROSS ST
Mailing Address - Street 2:SUITE 200C
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-7409
Mailing Address - Country:US
Mailing Address - Phone:404-579-1987
Mailing Address - Fax:770-643-3944
Practice Address - Street 1:1776 CENTURY BLVD NE
Practice Address - Street 2:SUITE A
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3397
Practice Address - Country:US
Practice Address - Phone:404-579-1987
Practice Address - Fax:770-643-3944
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002432103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical