Provider Demographics
NPI:1366569741
Name:FEIG, SUSAN LISA (PHD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:LISA
Last Name:FEIG
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5483 OXFORD CHASE WAY
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3034
Mailing Address - Country:US
Mailing Address - Phone:770-481-0035
Mailing Address - Fax:
Practice Address - Street 1:3159 ROYAL DR
Practice Address - Street 2:SUITE 330
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2461
Practice Address - Country:US
Practice Address - Phone:678-948-4016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1859103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical