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General NPI Number Information
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NPI Number | 1013894013
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Entity Type | Individual
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Provider Name | CAMILLE MARIE ROTY MS
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Gender | Female
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 1275 SHILOH RD NW STE 2160
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City | KENNESAW
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State | GA
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Zip | 30144-7185
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Country | US
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Telephone | 404-530-9564
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Fax | 678-341-0021
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Provider Business Mailing Address
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Address Line | 3562 PIEDMONT RD NE APT 401
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City | ATLANTA
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State | GA
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Zip | 30305-7004
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Country | US
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Telephone | 678-727-8645
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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