Provider Demographics
NPI:1659003671
Name:CATLETT, SIMONE MICHELLE (CCMA)
Entity Type:Individual
Prefix:MS
First Name:SIMONE
Middle Name:MICHELLE
Last Name:CATLETT
Suffix:
Gender:F
Credentials:CCMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7161 TURNER LAKE RD NW STE 6
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-2066
Mailing Address - Country:US
Mailing Address - Phone:404-859-4949
Mailing Address - Fax:
Practice Address - Street 1:7161 TURNER LAKE RD NW STE 6
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2066
Practice Address - Country:US
Practice Address - Phone:404-859-4949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAC6J7N4D8246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy