Provider Demographics
NPI:1376937037
Name:SPELMAN COLLEGE
Entity Type:Organization
Organization Name:SPELMAN COLLEGE
Other - Org Name:STUDENT HEALTH SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR, STUDENT HEALTH SERVICES
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:DENISE
Authorized Official - Last Name:DALTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD,MBA,MSN,WHNP-BC
Authorized Official - Phone:404-270-5245
Mailing Address - Street 1:350 SPELMAN LANE
Mailing Address - Street 2:BOX 1683
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30314
Mailing Address - Country:US
Mailing Address - Phone:404-270-5245
Mailing Address - Fax:
Practice Address - Street 1:350 SPELMAN LN SW
Practice Address - Street 2:BOX 1683
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30314-4395
Practice Address - Country:US
Practice Address - Phone:404-270-5245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SPELMAN COLLEGE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-03-20
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No261QF0050XAmbulatory Health Care FacilitiesClinic/CenterFamily Planning, Non-Surgical
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care