Provider Demographics
NPI:1235465733
Name:LAND, JULIA OLIVIA (PSYD, CRC)
Entity Type:Individual
Prefix:DR
First Name:JULIA
Middle Name:OLIVIA
Last Name:LAND
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Gender:F
Credentials:PSYD, CRC
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Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:404-638-5293
Practice Address - Street 1:2400 MOUNT ZION PKWY
Practice Address - Street 2:KAISER PERMANENTE SOUTHWOOD COMPREHENSIVE MEDICAL CENTE
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-2500
Practice Address - Country:US
Practice Address - Phone:770-603-3649
Practice Address - Fax:404-638-5293
Is Sole Proprietor?:No
Enumeration Date:2009-10-19
Last Update Date:2022-01-10
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Provider Licenses
StateLicense IDTaxonomies
GAPSY003268103TC0700X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical