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General NPI Number Information
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NPI Number | 1326643651
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Entity Type | Individual
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Provider Name | NADRAT NAHEEM NUHU PHD
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Gender | Female
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Dates
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Enumeration Date | 12/03/2020
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Last Update Date | 09/12/2024
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Provider Practice Location Address
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Address Line | 235 E PONCE DE LEON AVE STE 265
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City | DECATUR
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State | GA
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Zip | 30030-3452
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Country | US
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Telephone | 678-558-9428
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Fax |
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Provider Business Mailing Address
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Address Line | 1136 MASON WOODS DR NE
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City | ATLANTA
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State | GA
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Zip | 30329-3804
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Country | US
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Telephone | 678-558-9428
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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 | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY004456
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License Number State | GA
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