MEDICARE: MS. FOROOGH ELGUINDI MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	2536	GA

General Provider Information

NPI Number	:	1356509376
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. FOROOGH ELGUINDI MS

Provider Business Mailing Address
First Line	:	5123 DANIELL MILL RD
Second Line	:
City	:	WINSTON
State	:	GA
Zip	:	30187-1362
Country	:	US
Telephone Number	:	770-757-5309
Fax Number	:	770-489-0406

Provider Business Practice Location Address
First Line	:	5123 DANIELL MILL ROAD
Second Line	:
City	:	WINSTON
State	:	GA
Zip	:	30187-1362
Country	:	US
Telephone Number	:	770-757-5309
Fax Number	:	770-489-0406

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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