Healthcare Provider Details

I. General information

NPI: 1750042735
Provider Name (Legal Business Name): JANAY DENNIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/03/2022
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 NORTHRIDGE RD STE 140
SANDY SPRINGS GA
30350-3352
US

IV. Provider business mailing address

247 ARNEWOOD CIR
MCDONOUGH GA
30253-6024
US

V. Phone/Fax

Practice location:
  • Phone: 470-361-2000
  • Fax:
Mailing address:
  • Phone: 734-502-5971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-25-80927
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: