Provider Demographics
NPI:1366679219
Name:MOTLEY, JENNIFER DODT (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:DODT
Last Name:MOTLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2154 RADCLIFFE DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318-1644
Mailing Address - Country:US
Mailing Address - Phone:404-351-6392
Mailing Address - Fax:
Practice Address - Street 1:2004 RIDGEWOOD DR NE STE 216
Practice Address - Street 2:EMORY SCHOOL OF MED. PSYCHIATRY RESIDENCY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1031
Practice Address - Country:US
Practice Address - Phone:404-727-5157
Practice Address - Fax:404-727-4746
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0476262084P0800X
FLME 767412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry