Provider Demographics
NPI:1730415787
Name:GOLSEN, SARAH SALTZ (PSYD)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:SALTZ
Last Name:GOLSEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 SHILOH RD NW
Mailing Address - Street 2:SUITE 310
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-7194
Mailing Address - Country:US
Mailing Address - Phone:404-987-2531
Mailing Address - Fax:
Practice Address - Street 1:1050 SHILOH RD NW
Practice Address - Street 2:SUITE 310
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-7194
Practice Address - Country:US
Practice Address - Phone:404-987-2531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-27
Last Update Date:2012-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA3298103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist