Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 001883 | GA |
N | 101YM0800X | Mental Health Counselor | 001883 | GA |
N | 101YP2500X | Professional Counselor | 001883 | GA |
N | 225XE0001X | Environmental Modification | 003835 | GA |
N | 225XM0800X | Mental Health | 003835 | GA |
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 003835 | GA |
N | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 003835 | GA |
NPI | 1053636316 |
---|---|
Provider Name | Ms. Rashida Byams |
First Address | Decatur, GA 30031-0462 |
Second Address | Atlanta, GA 30305-2052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 30/03/2010 |