Healthcare Provider Details

I. General information

NPI: 1306242938
Provider Name (Legal Business Name): ALAINA BREITBERG HAMMOND PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALAINA JOY BREITBERG

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

IV. Provider business mailing address

2020 PEACHTREE RD NW
ATLANTA GA
30309-1465
US

V. Phone/Fax

Practice location:
  • Phone: 404-350-7601
  • Fax:
Mailing address:
  • Phone: 404-350-7601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number3375
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License NumberPSY 9066
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code103TR0400X
TaxonomyRehabilitation Psychologist
License Number022953-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: