Healthcare Provider Details

I. General information

NPI: 1336804038
Provider Name (Legal Business Name): RACHEL RENEE WARREN APC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2021
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 MERCHANTS SQ STE C
DALLAS GA
30132-0930
US

IV. Provider business mailing address

1344 MORRIS RD
ARAGON GA
30104-1403
US

V. Phone/Fax

Practice location:
  • Phone: 770-335-5305
  • Fax: 678-550-1155
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number007326
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: