Provider Demographics
NPI:1174149728
Name:CHILDREN'S AUTISM ASSESSMENT CENTER
Entity type:Organization
Organization Name:CHILDREN'S AUTISM ASSESSMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRANDI
Authorized Official - Middle Name:D
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:478-319-6028
Mailing Address - Street 1:360B WINDING RIVER DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-1931
Mailing Address - Country:US
Mailing Address - Phone:478-319-6028
Mailing Address - Fax:
Practice Address - Street 1:6667 VERNON WOODS DR # A-20
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-3215
Practice Address - Country:US
Practice Address - Phone:404-390-1322
Practice Address - Fax:404-835-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2020-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty