Healthcare Provider Details

I. General information

NPI: 1669971875
Provider Name (Legal Business Name): EE CONSULTING SOLUTION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6320 TOPAZ TRAL
ARLANTA GA
30349
US

IV. Provider business mailing address

6320 TOPAZ TRL
ATLANTA GA
30349-8472
US

V. Phone/Fax

Practice location:
  • Phone: 404-909-6540
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number00098759
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number00098759
License Number StateGA

VIII. Authorized Official

Name: TINA NECHELLE ALDRIDGE
Title or Position: OWNER
Credential: CRC
Phone: 404-909-6540