Provider Demographics
NPI:1669813580
Name:CENTER FOR BLACK WOMEN'S WELLNESS INC
Entity Type:Organization
Organization Name:CENTER FOR BLACK WOMEN'S WELLNESS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JEMEA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DORSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-688-9202
Mailing Address - Street 1:477 WINDSOR ST SW
Mailing Address - Street 2:SUITE #309
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-2530
Mailing Address - Country:US
Mailing Address - Phone:404-688-9202
Mailing Address - Fax:404-688-9435
Practice Address - Street 1:477 WINDSOR ST SW
Practice Address - Street 2:SUITE #309
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-2530
Practice Address - Country:US
Practice Address - Phone:404-688-9202
Practice Address - Fax:404-688-9435
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-08
Last Update Date:2013-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA033212207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty