Zacarias    Yanis  Jr  PSYD
Contract Details
Shepherd Center
Facility name
Provider ID
P000009243
NPI
1194213140
Tax ID
510141601
Effective Date
10/1/2018
Last Updated
10/25/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
Exhibit ID
AM_389
Location Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
United States
County
Fulton
Phone
4043522020 (Phone)
Billing Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
Billing Phone
4043522020
Specialty Type
Neuropsychology
Map
Address