Healthcare Provider Details

I. General information

NPI: 1801715263
Provider Name (Legal Business Name): AMNA AHMAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3675 CRESTWOOD PKWY NW STE 400
DULUTH GA
30096-5054
US

IV. Provider business mailing address

3427 HOPI PT
LAWRENCEVILLE GA
30044-3478
US

V. Phone/Fax

Practice location:
  • Phone: 404-384-7677
  • Fax:
Mailing address:
  • Phone: 404-384-7677
  • Fax: 404-384-7677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC017013
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: