Healthcare Provider Details

I. General information

NPI: 1720555816
Provider Name (Legal Business Name): MILENA GARCIA SKOLLAR LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2018
Last Update Date: 10/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 LAKE FORREST DR
ATLANTA GA
30328-3822
US

IV. Provider business mailing address

6100 LAKE FORREST DR
ATLANTA GA
30328-3822
US

V. Phone/Fax

Practice location:
  • Phone: 404-219-4828
  • Fax:
Mailing address:
  • Phone: 404-219-4828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW002857
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: