Provider Demographics
NPI:1699969709
Name:HOLLAHAN, NADYA (PHD)
Entity type:Individual
Prefix:DR
First Name:NADYA
Middle Name:
Last Name:HOLLAHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:NADYA
Other - Middle Name:
Other - Last Name:KHATCHIKIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2131 WOODMOOR LN
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-5440
Mailing Address - Country:US
Mailing Address - Phone:678-358-7112
Mailing Address - Fax:678-261-6545
Practice Address - Street 1:1955 CLIFF VALLEY WAY NE
Practice Address - Street 2:SUITE 115
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2476
Practice Address - Country:US
Practice Address - Phone:678-358-7112
Practice Address - Fax:678-261-6545
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103T00000X
GAPSY003278103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103T00000XBehavioral Health & Social Service ProvidersPsychologist