| Doctor Name: | DR. RAYMOND S KIERTEKLES |
| NPI Number: | 1851664924 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PH.D. |
| License Number: | 00942016 |
| Business Practice Address: | 4989 Peachtree Parkway Suite 200 Norcross, GA - 30092 |
| Business Phone Number: | 6789693379 |
| Business Fax Number: | 7702480537 |
| Mailing Address: | 4989 Peachtree Parkway, Suite 200 NORCROSS |
| State: | GA |
| Postal Code: | 30092 |
| Phone Number: | 6789693379 |
| Fax Number: | 7702480537 |
| NPI Enumeration Date: | 02/20/2012 |
| NPI Last Update Date: | 02/20/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101Y00000X |
| License Number: | 00942016 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |