Healthcare Provider Details
I. General information
NPI: 1164853479
Provider Name (Legal Business Name): MOLLY H. KLEIN MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/12/2013
Last Update Date: 12/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1800 HOWELL MILL RD NW SUITE 625
ATLANTA GA
30318-2538
US
IV. Provider business mailing address
1800 HOWELL MILL RD NW SUITE 625
ATLANTA GA
30318-2538
US
V. Phone/Fax
- Phone: 404-425-7949
- Fax: 404-425-7948
- Phone: 404-425-7949
- Fax: 404-425-7948
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 170300000X |
| Taxonomy | Genetic Counselor (M.S.) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: