| Braaten Neuroscience Llc | |
|
2701 N Decatur Rd Decatur GA 30033-5918 | |
| (612) 423-1888 | |
| Not Available |
| Full Name | Braaten Neuroscience Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 2701 N Decatur Rd, Decatur, Georgia |
| Authorized Official Name and Position | Alyssa Braaten (OWNER) |
| Authorized Official Contact | 6124231888 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Braaten Neuroscience Llc 400 Village Pkwy Ne Apt 138 Atlanta GA 30306-4363 Ph: (612) 423-1888 | Braaten Neuroscience Llc 2701 N Decatur Rd Decatur GA 30033-5918 Ph: (612) 423-1888 |
| NPI Number | 1235907718 |
|---|---|
| Provider Enumeration Date | 12/14/2023 |
| Last Update Date | 12/14/2023 |
| Certification Date | 12/14/2023 |
| Medicare PECOS PAC ID | 8325570849 |
|---|---|
| Medicare Enrollment ID | O20241022001360 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235907718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | Alyssa Braaten |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013153071 PECOS PAC ID: 2365679107 Enrollment ID: I20220415000664 |
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