National Provider Identifier Database

IDARA I AJALA
Psychiatric/Mental Health

Contact Information

IDARA I AJALA
2782 N COBB PKWY
KENNESAW, GA  30152-3472
Phone: 866-389-2727
Fax:
Website:
Specialty Taxonomy Code
* Psychiatric/Mental Health 363LP0808X
Family 363LF0000X

* Indicates primary specialty

NPI Profile & details for IDARA I AJALA

NPI Number 1740826643
Credentials
Entity Individual
Enumeration date 11/26/2019
Last updated 12/17/2025 - About 6 months ago
Sole proprietor1 No
Identifiers
  • CT License #: 014096
  • GA License #: GAA-NP001676
  • MD License #: AC007091
  • NC License #: 5021546
  • ND License #: 201317
  • NJ License #: 26NJ15319800
  • NY License #: 344819
  • NY License #: F344819-01
  • PA License #: SP032801
  • SC License #: 29580
  • SD License #: CP003464
  • TN License #: 37662
  • VA License #: 0024192081
  • WI License #: 1616433
  • WV License #: 121412
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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