Healthcare Provider Details

I. General information

NPI: 1649197187
Provider Name (Legal Business Name): NATHALIA ROWE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 SENOIA RD
TYRONE GA
30290-1625
US

IV. Provider business mailing address

154 LAFAYETTE DR
FAYETTEVILLE GA
30214-5329
US

V. Phone/Fax

Practice location:
  • Phone: 404-839-7934
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: