| Unlock Dreams | |
|
575 Cranberry Pl Roswell GA 30076-2351 | |
| (678) 852-2987 | |
| (888) 375-4037 |
| Full Name | Unlock Dreams |
|---|---|
| Speciality | Social Worker |
| Location | 575 Cranberry Pl, Roswell, Georgia |
| Authorized Official Name and Position | Tiquicha Harris (DIRECTOR) |
| Authorized Official Contact | 6788522987 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Unlock Dreams 1425 Market Blvd Ste 530-145 Roswell GA 30076-6708 Ph: (678) 852-2987 | Unlock Dreams 575 Cranberry Pl Roswell GA 30076-2351 Ph: (678) 852-2987 |
| NPI Number | 1104508431 |
|---|---|
| Provider Enumeration Date | 08/04/2023 |
| Last Update Date | 08/04/2023 |
| Certification Date | 08/04/2023 |
| Medicare PECOS PAC ID | 3779014261 |
|---|---|
| Medicare Enrollment ID | O20241008003738 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104508431 | NPI | - | NPPES |
| Provider Name | Tiquicha M Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790916609 PECOS PAC ID: 7416394721 Enrollment ID: I20240322000593 |
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