Provider Demographics
NPI:1114471703
Name:NAIDU, HYMA
Entity Type:Individual
Prefix:MS
First Name:HYMA
Middle Name:
Last Name:NAIDU
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:HYMA
Other - Middle Name:
Other - Last Name:NAIDU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MFT
Mailing Address - Street 1:2965 EVANS OAKS CT
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-4300
Mailing Address - Country:US
Mailing Address - Phone:770-883-8390
Mailing Address - Fax:
Practice Address - Street 1:3648 CHAMBLEE TUCKER RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30341-4403
Practice Address - Country:US
Practice Address - Phone:770-493-7750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility