Provider Demographics
NPI:1467688820
Name:ANWAR, FARIDA (PH D)
Entity Type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:
Last Name:ANWAR
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 MAXWELL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-2045
Mailing Address - Country:US
Mailing Address - Phone:770-442-9447
Mailing Address - Fax:770-442-1915
Practice Address - Street 1:314 MAXWELL RD STE 400
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009
Practice Address - Country:US
Practice Address - Phone:770-442-9447
Practice Address - Fax:770-442-1915
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004254103TC0700X
GAPSY0004254103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty