NPI Code Details Logo

NPI 1578427019

NPI 1578427019 : MAKYRA FARMER : ATLANTA, GA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1578427019
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MAKYRA FARMER
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    12/10/2025
-----------------------------------------------------
    Last Update Date     |    12/10/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    1800 PHOENIX BLVD STE 400 
-----------------------------------------------------
    City                 |    ATLANTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30349-5560
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    888-329-4535
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    391 17TH ST NW UNIT 1042 
-----------------------------------------------------
    City                 |    ATLANTA
-----------------------------------------------------
    State                |    GA
-----------------------------------------------------
    Zip                  |    30363-1165
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106S00000X
-----------------------------------------------------
    Taxonomy Name        |    Behavior Technician
-----------------------------------------------------
    License Number       |    RBT-25-490830
-----------------------------------------------------
    License Number State |    GA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.