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General NPI Number Information
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NPI Number | 1285749671
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Entity Type | Individual
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Provider Name | ADINA G WEINER-JAGODA PSY.D
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Gender | Female
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 181 14TH ST NE STE 450
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City | ATLANTA
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State | GA
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Zip | 30309-3674
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Country | US
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Telephone | 404-873-6178
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Fax | 404-873-0342
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Provider Business Mailing Address
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Address Line | 1460 LACHONA CT NE
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City | ATLANTA
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State | GA
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Zip | 30329-3411
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Country | US
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Telephone | 404-325-5703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 537
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License Number State | GA
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