MEDICARE: ROBERT W POYNTER III M.S., ED.S

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	APC002475	GA

General Provider Information

NPI Number	:	1881973568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT W POYNTER III M.S., ED.S

Provider Business Mailing Address
First Line	:	960 E PACES FERRY RD NE
Second Line	:	APT. 510
City	:	ATLANTA
State	:	GA
Zip	:	30326-1124
Country	:	US
Telephone Number	:	404-993-0438
Fax Number	:

Provider Business Practice Location Address
First Line	:	2050 ROSWELL RD
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30062-3801
Country	:	US
Telephone Number	:	678-784-4293
Fax Number	:

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

Provider Enumeration Date	:	08/11/2011
Last Update Date	:	08/11/2011

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