Provider Demographics
NPI:1538728985
Name:ENGLISH, MIMI Y
Entity type:Individual
Prefix:MISS
First Name:MIMI
Middle Name:Y
Last Name:ENGLISH
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 1:2553 TERRACE TRL
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30035-3514
Mailing Address - Country:US
Mailing Address - Phone:404-438-8791
Mailing Address - Fax:
Practice Address - Street 1:2553 TERRACE TRL
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-3514
Practice Address - Country:US
Practice Address - Phone:404-438-8791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-10
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator