Unique And Innovative Solutions Llc | |
3645 Marketplace Blvd Ste 130-669 East Point GA 30344-5747 | |
(404) 217-8657 | |
Not Available |
Full Name | Unique And Innovative Solutions Llc |
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Speciality | Psychologist |
Location | 3645 Marketplace Blvd Ste 130-669, East Point, Georgia |
Authorized Official Name and Position | Tabitha Delaina Ball (OWNER) |
Authorized Official Contact | 6077951235 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Unique And Innovative Solutions Llc 3645 Marketplace Blvd Suite 130-669 East Point GA 30344-5747 Ph: (404) 217-8657 | Unique And Innovative Solutions Llc 3645 Marketplace Blvd Ste 130-669 East Point GA 30344-5747 Ph: (404) 217-8657 |
NPI Number | 1023568755 |
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Provider Enumeration Date | 10/05/2016 |
Last Update Date | 09/27/2021 |
Certification Date | 09/27/2021 |
Medicare PECOS PAC ID | 9739461773 |
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Medicare Enrollment ID | O20170126001343 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023568755 | NPI | - | NPPES |
003183738C | Medicaid | GA |
Provider Name | Tabitha D Ball |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1710212196 PECOS PAC ID: 0345522389 Enrollment ID: I20170127001378 |
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