Provider Demographics
NPI:1467474346
Name:ABRAMOVICH, EVELYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:EVELYN
Middle Name:
Last Name:ABRAMOVICH
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 1:316 ALEXANDER ST SE STE 8
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-2001
Mailing Address - Country:US
Mailing Address - Phone:770-590-9151
Mailing Address - Fax:770-590-9152
Practice Address - Street 1:316 ALEXANDER ST SE STE 8
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-2001
Practice Address - Country:US
Practice Address - Phone:770-590-9151
Practice Address - Fax:770-590-9152
Is Sole Proprietor?:No
Enumeration Date:2006-07-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002982103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical