Healthcare Provider Details

I. General information

NPI: 1780862961
Provider Name (Legal Business Name): REBEKKA VATTER LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2008
Last Update Date: 04/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5883 GLENRIDGE DR STE 170
SANDY SPRINGS GA
30328-5570
US

IV. Provider business mailing address

170 BOULEVARD SE APT H419
ATLANTA GA
30312-2381
US

V. Phone/Fax

Practice location:
  • Phone: 404-394-1899
  • Fax:
Mailing address:
  • Phone: 404-394-1899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT001034
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: