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General NPI Number Information
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NPI Number | 1962071563
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Entity Type | Individual
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Provider Name | SARALYN WILSON BRACKEN CRT, RRT
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Gender | Female
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Dates
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Enumeration Date | 06/18/2021
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Last Update Date | 06/18/2021
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Provider Practice Location Address
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Address Line | 1001 JOHNSON FY RD NE
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City | SANDY SPRINGS
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State | GA
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Zip | 30342-1605
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Country | US
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Telephone | 404-785-5437
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Fax |
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Provider Business Mailing Address
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Address Line | 415 MORGAN FALLS RD APT 1102
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City | SANDY SPRINGS
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State | GA
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Zip | 30350-5852
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Country | US
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Telephone | 678-223-1279
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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 | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 175992
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number | 11179
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License Number State | GA
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