Provider Demographics
NPI:1356470462
Name:IMHOFF, ANNE REMONDI (PHD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:REMONDI
Last Name:IMHOFF
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 1:11705 RED MAPLE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30005-6714
Mailing Address - Country:US
Mailing Address - Phone:770-410-0321
Mailing Address - Fax:
Practice Address - Street 1:6340 SUGARLOAF PKWY STE 200
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4329
Practice Address - Country:US
Practice Address - Phone:678-522-5357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68 041075103T00000X
MA8516103T00000X
GAPSY 002360103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist