Healthcare Provider Details

I. General information

NPI: 1780553826
Provider Name (Legal Business Name): CINDY AYALA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2025
Last Update Date: 11/04/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3005 BRECKINRIDGE BLVD STE 230
DULUTH GA
30096-4978
US

IV. Provider business mailing address

5807 BROOKLYN LN
NORCROSS GA
30093-4177
US

V. Phone/Fax

Practice location:
  • Phone: 404-224-9346
  • Fax:
Mailing address:
  • Phone: 678-629-7873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: