Provider Demographics
NPI:1861831562
Name:GEORGIA NEUROBEHAVIORAL ASSOCIATES, LLC
Entity Type:Organization
Organization Name:GEORGIA NEUROBEHAVIORAL ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLISON
Authorized Official - Middle Name:CURVING
Authorized Official - Last Name:DOERR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, BCBA-D
Authorized Official - Phone:770-213-3594
Mailing Address - Street 1:140 E MARIETTA ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-3013
Mailing Address - Country:US
Mailing Address - Phone:770-213-3594
Mailing Address - Fax:
Practice Address - Street 1:140 E MARIETTA ST
Practice Address - Street 2:SUITE 301
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-3013
Practice Address - Country:US
Practice Address - Phone:770-213-3594
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
GA2283103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty