Provider Demographics
NPI:1366917726
Name:GBR PSYCH ASSOCIATES LLC
Entity type:Organization
Organization Name:GBR PSYCH ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:POSTDOCTORAL FELLOW
Authorized Official - Prefix:DR
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:BEATRIZ
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:678-701-9559
Mailing Address - Street 1:675 SEMINOLE AVE NE STE 307
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30307-3416
Mailing Address - Country:US
Mailing Address - Phone:678-701-9559
Mailing Address - Fax:
Practice Address - Street 1:675 SEMINOLE AVE NE STE 307
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30307-3416
Practice Address - Country:US
Practice Address - Phone:678-701-9559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty