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General NPI Number Information
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NPI Number | 1366250367
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Entity Type | Individual
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Provider Name | ERMESE FINNIE-SITAL
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Gender | Female
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Dates
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Enumeration Date | 12/21/2024
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Last Update Date | 12/21/2024
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Provider Practice Location Address
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Address Line | 3864 CHIMNEY STONE CT
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City | ELLENWOOD
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State | GA
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Zip | 30294-1409
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Country | US
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Telephone | 470-264-1211
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Fax |
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Provider Business Mailing Address
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Address Line | 1445 WOODMONT LN NW
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City | ATLANTA
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State | GA
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Zip | 30318-2866
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Country | US
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Telephone | 470-264-1131
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCAS-22331
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License Number State | NC
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