Provider Demographics
NPI:1013097989
Name:ZWEBEN, RENA BETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:RENA
Middle Name:BETH
Last Name:ZWEBEN
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 1:3115 ROSWELL RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-7605
Mailing Address - Country:US
Mailing Address - Phone:678-560-7755
Mailing Address - Fax:678-560-9976
Practice Address - Street 1:3115 ROSWELL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-7605
Practice Address - Country:US
Practice Address - Phone:678-560-7755
Practice Address - Fax:678-560-9976
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1153103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBFJSMedicare ID - Type Unspecified