MEDICARE: MRS. GLORIA FAYELYN BILODEAU MSW

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
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1700719812
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. GLORIA FAYELYN BILODEAU MSW

Provider Business Mailing Address
First Line	:	1640 POWERS FERRY RD SE # 4
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-5491
Country	:	US
Telephone Number	:	678-336-6875
Fax Number	:

Provider Business Practice Location Address
First Line	:	1640 POWERS FERRY RD SE # 4
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-5491
Country	:	US
Telephone Number	:	678-336-6875
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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