Healthcare Provider Details

I. General information

NPI: 1225919327
Provider Name (Legal Business Name): CHIMDINDU CHINWENWA OHAYAGHA PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

IV. Provider business mailing address

2934 OSHIELDS CT SW
MARIETTA GA
30060-6377
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-2020
  • Fax:
Mailing address:
  • Phone: 770-866-6891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: