Provider Demographics
NPI:1558571505
Name:RUBIN, CLARE P (PHD)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:P
Last Name:RUBIN
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 1:289 ROBIN HOOD RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2635
Mailing Address - Country:US
Mailing Address - Phone:404-617-0040
Mailing Address - Fax:
Practice Address - Street 1:3384 PEACHTREE RD NE
Practice Address - Street 2:SUITE 450
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-1181
Practice Address - Country:US
Practice Address - Phone:404-364-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY001313103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical