Provider Demographics
NPI:1598162620
Name:DELTA POINTE BROKERS & CONSULTING FIRM USA INC
Entity Type:Organization
Organization Name:DELTA POINTE BROKERS & CONSULTING FIRM USA INC
Other - Org Name:DELTA POINTE COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:ESEZOBOR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:404-966-6776
Mailing Address - Street 1:3411 AUSTELL RD SW
Mailing Address - Street 2:SUITE 102
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30008-5796
Mailing Address - Country:US
Mailing Address - Phone:404-966-6776
Mailing Address - Fax:
Practice Address - Street 1:3411 AUSTELL RD SW
Practice Address - Street 2:SUITE 102
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30008-5796
Practice Address - Country:US
Practice Address - Phone:404-966-6776
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC002158251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health