Individual
SELAM MENGISTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
33 GILMER ST SE, ATLANTA, GA 30303-3044
(404) 413-2000
Mailing address
33 GILMER ST SE, ATLANTA, GA 30303-3044
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
212292
GA
Other
Enumeration date
01/08/2022
Last updated
04/22/2025
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