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General NPI Number Information
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NPI Number | 1881991404
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Entity Type | Organization
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Legal Business Name | A HEALING PARADIGM LLC
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Dates
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Enumeration Date | 02/16/2011
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Last Update Date | 02/16/2011
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Provider Practice Location Address
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Address Line | 950 DANNON VW SW SUITE 4201
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City | ATLANTA
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State | GA
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Zip | 30331-2160
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Country | US
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Telephone | 404-635-6021
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Fax | 404-601-7347
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Provider Business Mailing Address
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Address Line | 950 DANNON VW SW SUITE 4201
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City | ATLANTA
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State | GA
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Zip | 30331-2160
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Country | US
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Telephone | 404-635-6021
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Fax | 404-601-7347
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Authorized Official
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Title or Position | DIRECTOR OF BILLING
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Name | TAIWANA HAWKINS
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Credential |
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Telephone | 404-671-9213
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC1900X
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Taxonomy Name | Counseling Psychologist
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License Number | PSY003437
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License Number State | GA
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