Provider Demographics
NPI:1134450729
Name:SUBHANI, RABIA (PSYD)
Entity type:Individual
Prefix:DR
First Name:RABIA
Middle Name:
Last Name:SUBHANI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:RABIA
Other - Middle Name:
Other - Last Name:SUBHANI-SIDDIQUE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4519 WOODRUFF RD STE 4, #375
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:513-512-4645
Mailing Address - Fax:
Practice Address - Street 1:4519 WOODRUFF RD STE 4, #375
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:513-512-4645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3392103TC0700X, 103TC2200X, 103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent