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General NPI Number Information
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NPI Number | 1538657283
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Entity Type | Organization
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Legal Business Name | COLLABORATIVE RESOURCE SOLUTIONS LLC
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Dates
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Enumeration Date | 04/27/2018
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 5883 GLENRIDGE DR STE 170
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City | SANDY SPRINGS
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State | GA
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Zip | 30328
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Country | US
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Telephone | 404-394-1899
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Fax |
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Provider Business Mailing Address
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Address Line | 170 BOULEVARD SE APT H419
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City | ATLANTA
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State | GA
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Zip | 30312-2381
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Country | US
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Telephone | 404-394-1899
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | REBEKKA VATTER
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Credential |
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Telephone | 404-394-1899
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFT001034
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License Number State | GA
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