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General NPI Number Information
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NPI Number | 1811285836
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Entity Type | Individual
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Provider Name | SYNITA MEQUINN HUDGINS PHD
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Gender | Female
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 55 ATLANTA STREET SE
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City | MARIETTA
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State | GA
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Zip | 30060
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Country | US
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Telephone | 470-407-3127
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Fax |
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Provider Business Mailing Address
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Address Line | 2774 COBB PKWY NW SUITE 109, #379
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City | KENNESAW
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State | GA
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Zip | 30152
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Country | US
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Telephone | 470-407-3127
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 004946
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY004326
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | PSY004326
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | PSY004326
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY004326
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License Number State | GA
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Taxonomy #6
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY004326
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License Number State | GA
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Taxonomy #7
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | PSY004326
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License Number State | GA
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