Provider Demographics
NPI:1992537807
Name:THE INTERSECTION
Entity type:Organization
Organization Name:THE INTERSECTION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BODYARTIST
Authorized Official - Prefix:
Authorized Official - First Name:ARIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:
Authorized Official - Credentials:SA-C/PMU
Authorized Official - Phone:720-327-7390
Mailing Address - Street 1:4614 MCTYRE WAY NW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-5622
Mailing Address - Country:US
Mailing Address - Phone:720-327-7390
Mailing Address - Fax:
Practice Address - Street 1:425 ERNEST W BARRETT PKWY NW # LOFT22
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-4990
Practice Address - Country:US
Practice Address - Phone:720-327-7390
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-19
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty