Healthcare Provider Details

I. General information

NPI: 1871687608
Provider Name (Legal Business Name): AARON DAVID FELDMAN PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 POWERS FERRY RD SE BUILDING 9, SUITE 100
MARIETTA GA
30067-5491
US

IV. Provider business mailing address

1272 HOLLY LN NE
ATLANTA GA
30329-3512
US

V. Phone/Fax

Practice location:
  • Phone: 770-953-0080
  • Fax: 770-953-0031
Mailing address:
  • Phone: 770-953-0080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY002921
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY002921
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: