Healthcare Provider Details

I. General information

NPI: 1699090597
Provider Name (Legal Business Name): ZENOVIA L PALMER MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2010
Last Update Date: 04/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3174 IMPERIAL CIR SW
ATLANTA GA
30311-5209
US

IV. Provider business mailing address

3174 IMPERIAL CIR SW
ATLANTA GA
30311-5209
US

V. Phone/Fax

Practice location:
  • Phone: 404-783-1814
  • Fax:
Mailing address:
  • Phone: 404-783-1814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT005318
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: