Provider Demographics
NPI:1235969841
Name:NOWAK, MEREDITH MARIE (EDS, MED, NCC)
Entity type:Individual
Prefix:MISS
First Name:MEREDITH
Middle Name:MARIE
Last Name:NOWAK
Suffix:
Gender:F
Credentials:EDS, MED, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 W CROSSVILLE RD STE 514
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-2964
Mailing Address - Country:US
Mailing Address - Phone:770-702-2982
Mailing Address - Fax:
Practice Address - Street 1:45 W CROSSVILLE RD STE 514
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-2964
Practice Address - Country:US
Practice Address - Phone:770-702-2982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-07
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health