Healthcare Provider Details

I. General information

NPI: 1356016984
Provider Name (Legal Business Name): MARKIE ADAMCZYK BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2021
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2010 MONTREAL RD
TUCKER GA
30084-5203
US

IV. Provider business mailing address

500 SUN VALLEY DR STE G1
ROSWELL GA
30076-5639
US

V. Phone/Fax

Practice location:
  • Phone: 470-283-0160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-180322
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: