Provider Demographics
NPI:1841854148
Name:FARIDA ANWAR PHD
Entity type:Organization
Organization Name:FARIDA ANWAR PHD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FARIDA
Authorized Official - Middle Name:
Authorized Official - Last Name:ANWAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:626-221-6104
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:626-211-6104
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:30009-2045
Practice Address - Country:US
Practice Address - Phone:626-221-6104
Practice Address - Fax:770-442-1915
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty