Healthcare Provider Details

I. General information

NPI: 1558987974
Provider Name (Legal Business Name): JANE TYLER FINKLEA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2020
Last Update Date: 06/22/2020
Certification Date: 06/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PHARR RD NE STE 605
ATLANTA GA
30305-3469
US

IV. Provider business mailing address

550 PHARR RD NE STE 605
ATLANTA GA
30305-3469
US

V. Phone/Fax

Practice location:
  • Phone: 404-235-5982
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number004227
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: