Healthcare Provider Details

I. General information

NPI: 1114352580
Provider Name (Legal Business Name): ZAREENA MALONE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2013
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 CARPENTER DR NE SUITE 400
SANDY SPRINGS GA
30328-0000
US

IV. Provider business mailing address

270 CARPENTER DR NE SUITE 400
SANDY SPRINGS GA
30328-0000
US

V. Phone/Fax

Practice location:
  • Phone: 678-460-0345
  • Fax: 678-460-0350
Mailing address:
  • Phone: 678-460-0345
  • Fax: 678-460-0350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberMSW007025
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: