Provider Demographics
NPI:1073168100
Name:ROSKI-HOLDO, RENEE MICHELLE (MAMFT)
Entity Type:Individual
Prefix:MRS
First Name:RENEE
Middle Name:MICHELLE
Last Name:ROSKI-HOLDO
Suffix:
Gender:F
Credentials:MAMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 FORT ST NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1708
Mailing Address - Country:US
Mailing Address - Phone:404-731-8621
Mailing Address - Fax:
Practice Address - Street 1:1900 THE EXCHANGE SE STE 180
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2049
Practice Address - Country:US
Practice Address - Phone:770-575-9393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-06
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist