Provider Demographics
NPI:1922214154
Name:BARBER, JILL (PHD)
Entity Type:Individual
Prefix:DR
First Name:JILL
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2255 LAVISTA WOODS DR
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4212
Mailing Address - Country:US
Mailing Address - Phone:404-630-8238
Mailing Address - Fax:404-894-1804
Practice Address - Street 1:2751 BUFORD HWY NE
Practice Address - Street 2:SUITE 401
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3207
Practice Address - Country:US
Practice Address - Phone:404-630-8238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2394103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling