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General NPI Number Information
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NPI Number | 1437369246
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Entity Type | Individual
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Provider Name | VAHID AZIMZADEH SADEGHI M.A., L.M.F.T.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2150 PEACHFORD RD SUITE S,
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City | ATLANTA
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State | GA
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Zip | 30338-6520
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Country | US
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Telephone | 770-457-1848
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Fax | 770-516-3018
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Provider Business Mailing Address
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Address Line | 2150 PEACHFORD RD SUITE S,
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City | ATLANTA
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State | GA
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Zip | 30338-6520
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Country | US
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Telephone | 770-457-1848
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Fax | 770-516-3018
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT000742
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License Number State | GA
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