Healthcare Provider Details

I. General information

NPI: 1336070069
Provider Name (Legal Business Name): VALERIA A AMAYA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2026
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3993 LAWRENCEVILLE HWY NW STE 110
LILBURN GA
30047-2831
US

IV. Provider business mailing address

381 MCCLAIN DR
MCDONOUGH GA
30252-6117
US

V. Phone/Fax

Practice location:
  • Phone: 404-407-5224
  • Fax:
Mailing address:
  • Phone: 404-207-2335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: