Provider Demographics
NPI:1225449309
Name:USWATTE, GITENDRA (PHD)
Entity Type:Individual
Prefix:DR
First Name:GITENDRA
Middle Name:
Last Name:USWATTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:GITENDRA
Other - Middle Name:
Other - Last Name:USWATTE-ARATCHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1720 2ND AVE S
Mailing Address - Street 2:CH415
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35294-1170
Mailing Address - Country:US
Mailing Address - Phone:205-975-5089
Mailing Address - Fax:205-975-6140
Practice Address - Street 1:1720 2ND AVE S
Practice Address - Street 2:CH415
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35294-1170
Practice Address - Country:US
Practice Address - Phone:205-975-5089
Practice Address - Fax:205-975-6140
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1290103TC0700X, 103TH0004X, 103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth