Healthcare Provider Details

I. General information

NPI: 1013097989
Provider Name (Legal Business Name): RENA BETH ZWEBEN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 BROWNRIDGE CT
MARIETTA GA
30062-2670
US

IV. Provider business mailing address

2730 BROWNRIDGE CT
MARIETTA GA
30062-2670
US

V. Phone/Fax

Practice location:
  • Phone: 678-560-7755
  • Fax: 678-560-9976
Mailing address:
  • Phone: 678-560-7755
  • Fax: 678-560-9976

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1153
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: