Provider Demographics
NPI:1225780869
Name:HALE, KATHERINE E (PHD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:E
Last Name:HALE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3715 NORTHSIDE PKWY
Mailing Address - Street 2:BLDG 100 - STE 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327
Mailing Address - Country:US
Mailing Address - Phone:770-415-5446
Mailing Address - Fax:
Practice Address - Street 1:3715 NORTHSIDE PKWY
Practice Address - Street 2:BLDG 100 - STE 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327
Practice Address - Country:US
Practice Address - Phone:770-415-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-25
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004556103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical