Organization
UNIQUE AND INNOVATIVE SOLUTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TABITHA DELAINA BALL PH.D. (OWNER)
(607) 795-1235
Entity
Organization
Contact information
Practice address
3645 MARKETPLACE BLVD STE 130-669, EAST POINT, GA 30344-5747
(404) 217-8657
Mailing address
3645 MARKETPLACE BLVD, SUITE 130-669, EAST POINT, GA 30344-5747
(404) 217-8657
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
Primary
PSY003839
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003183738C
—
GA
Enumeration date
10/05/2016
Last updated
09/27/2021
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