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General NPI Number Information
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NPI Number | 1447539671
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Entity Type | Organization
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Legal Business Name | ML ENRICHMENT SERVICES INC.
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 02/09/2015
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Provider Practice Location Address
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Address Line | 5682 PALAZZO WAY UNIT 101
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2500
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Country | US
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Telephone | 404-397-1976
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Fax |
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Provider Business Mailing Address
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Address Line | 5682 PALAZZO WAY SUITE 101
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-2500
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Country | US
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Telephone | 404-397-1976
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MICHELLE LINDSAY-BAILEY
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Credential | LCSW
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Telephone | 404-397-1976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW003799
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License Number State | GA
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