Provider Information for 1538303201
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Ms. KATHLEEN E BAZILE Ph.D., LPC
Sex: Female
NPI: 1538303201
Last Updated: 2024-03-21
Certification Date: 2024-03-21
Certification Date: 2024-03-21
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1538303201 | ||||||||||||
| Enumeration Date | 2009-04-26 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | PO BOX 191321 ATLANTA, GA 31119-1321 United States Phone: 407-529-8289 | Fax: | ||||||||||||
| Primary Practice Address | 1900 THE EXCHANGE SE STE 100 ATLANTA, GA 30339-2022 United States Phone: 470-231-6178 | Fax: | ||||||||||||
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