IndividualActive
Anna Wise, PHD
NPI 1013410398 · Clinical Psychologist · Atlanta, GA
Provider details
- NPI number
- 1013410398
- Entity type
- Individual
- Primary specialty
- Clinical PsychologistBehavioral Health & Social Service Providers
- Credential
- PHD
- Sex
- Female
- Sole proprietor
- No
- License
- PSY004597 (GA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Mental Health Counselor101YM0800X
Behavioral Health & Social Service Providers
Practice location
12 Executive Park Dr Ne Ste 300
Atlanta, GA 30329-2206
Phone: (404) 727-4592
Fax: (330) 678-3677
Approximate (ZIP-level) locationGet directions
Mailing address
12 Executive Park Dr Ne Ste 300
Atlanta, GA 30329-2206
Registry dates
- Enumerated
- 2018-03-13
- Last updated
- 2022-05-03
- Certified
- 2022-05-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.