Provider Demographics
NPI:1710596994
Name:THE REAL THERAPISTS OF ATLANTA, LLC.
Entity Type:Organization
Organization Name:THE REAL THERAPISTS OF ATLANTA, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:TARA
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, NCC, LPC,
Authorized Official - Phone:678-898-4941
Mailing Address - Street 1:626 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO
Mailing Address - State:GA
Mailing Address - Zip Code:30268-1141
Mailing Address - Country:US
Mailing Address - Phone:678-898-4941
Mailing Address - Fax:678-818-4619
Practice Address - Street 1:626 MAIN ST
Practice Address - Street 2:
Practice Address - City:PALMETTO
Practice Address - State:GA
Practice Address - Zip Code:30268-1141
Practice Address - Country:US
Practice Address - Phone:678-898-4941
Practice Address - Fax:678-818-4619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health