Provider Demographics
NPI:1104997741
Name:TARTT, ALDUAN RABZE (PHD)
Entity type:Individual
Prefix:DR
First Name:ALDUAN
Middle Name:RABZE
Last Name:TARTT
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 1:315 W PONCE DE LEON AVE
Mailing Address - Street 2:STE 525
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-2400
Mailing Address - Country:US
Mailing Address - Phone:404-377-4757
Mailing Address - Fax:404-370-8751
Practice Address - Street 1:315 W PONCE DE LEON AVE
Practice Address - Street 2:STE 525
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2400
Practice Address - Country:US
Practice Address - Phone:404-377-4757
Practice Address - Fax:404-370-8751
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002535103T00000X, 103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical