Provider Demographics
NPI:1316002462
Name:DRUTMAN, HOWARD (PHD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:
Last Name:DRUTMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 OLD ROSWELL LAKES PKWY
Mailing Address - Street 2:SUITE 340
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-8663
Mailing Address - Country:US
Mailing Address - Phone:678-867-7020
Mailing Address - Fax:678-205-5006
Practice Address - Street 1:900 OLD ROSWELL LAKES PKWY
Practice Address - Street 2:SUITE 340
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-8663
Practice Address - Country:US
Practice Address - Phone:678-867-7020
Practice Address - Fax:678-205-5006
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2013-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2543103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical