Provider Demographics
NPI:1033431481
Name:ZOMALT, SAUNDRIA C
Entity type:Individual
Prefix:
First Name:SAUNDRIA
Middle Name:C
Last Name:ZOMALT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 6
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-3007
Mailing Address - Country:US
Mailing Address - Phone:562-668-3557
Mailing Address - Fax:
Practice Address - Street 1:4200 NORTHSIDE PKWY NW BLDG 6
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-3007
Practice Address - Country:US
Practice Address - Phone:562-668-3557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-25
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC1843101YM0800X
225400000X
GALPC010974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
GALPC010974OtherGA BOARD OF PROFESSIONAL COUNSELORS