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NPI Code Detail

MEDICARE: RONY PREVOT

MEDICARE: RONY PREVOT
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
1103K00000XBehavior Analyst1-22-61763GA

General Provider Information

NPI Number : 1750894325
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONY PREVOT
Provider Business Mailing Address
First Line : PO BOX 931142
Second Line :
City : ATLANTA
State : GA
Zip : 31193-1142
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1511 JOHNSON FERRY RD STE 145
Second Line :
City : MARIETTA
State : GA
Zip : 30062-6403
Country : US
Telephone Number : 470-231-2377
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/06/2017
Last Update Date : 11/03/2023

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