Provider Demographics
NPI:1245476639
Name:EINHORN, MARC DAVID (PSYD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:DAVID
Last Name:EINHORN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11755 POINTE PL
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4656
Mailing Address - Country:US
Mailing Address - Phone:404-401-0555
Mailing Address - Fax:
Practice Address - Street 1:11755 POINTE PL
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4656
Practice Address - Country:US
Practice Address - Phone:404-401-0555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2268103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic