Provider Demographics
NPI:1205971892
Name:HUFF, FREDERICK W (PHD)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:W
Last Name:HUFF
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:840 CHURCH ST NE
Mailing Address - Street 2:BLDG. F1
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8936
Mailing Address - Country:US
Mailing Address - Phone:770-422-8705
Mailing Address - Fax:
Practice Address - Street 1:840 CHURCH ST NE
Practice Address - Street 2:BLDG. F1
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8936
Practice Address - Country:US
Practice Address - Phone:770-422-8705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000185103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical