Provider Demographics
NPI:1639228935
Name:WOLC, SCARLET (CST)
Entity type:Individual
Prefix:MS
First Name:SCARLET
Middle Name:
Last Name:WOLC
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 HAMMOND DR NE
Mailing Address - Street 2:BUILDING 19 STE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5532
Mailing Address - Country:US
Mailing Address - Phone:404-257-0363
Mailing Address - Fax:404-257-0338
Practice Address - Street 1:750 HAMMOND DR NE
Practice Address - Street 2:BUILDING 19 STE 300
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-5532
Practice Address - Country:US
Practice Address - Phone:404-257-0363
Practice Address - Fax:404-257-0338
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist