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NPI Code Detail

MEDICARE: NANTHA SIVARAJAH COUSENS

MEDICARE: NANTHA SIVARAJAH COUSENS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianRBT-25431341GA

General Provider Information

NPI Number : 1124981246
Entity Type Code : Individual
Provider Name (Legal Business Name) : NANTHA SIVARAJAH COUSENS
Provider Business Mailing Address
First Line : 2001 WESTSIDE PKWY STE 250
Second Line :
City : ALPHARETTA
State : GA
Zip : 30004-4992
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2001 WESTSIDE PKWY STE 250
Second Line :
City : ALPHARETTA
State : GA
Zip : 30004-4992
Country : US
Telephone Number : 404-882-8522
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2025
Last Update Date : 12/05/2025

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