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NPI Code Detail

MEDICARE: MARLET EUFRACIO

MEDICARE:   MARLET  EUFRACIO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior Analyst1-23-64810GA

General Provider Information

NPI Number : 1124423991
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARLET EUFRACIO
Provider Business Mailing Address
First Line : 6505 SHILOH RD STE 100
Second Line :
City : ALPHARETTA
State : GA
Zip : 30005-1645
Country : US
Telephone Number : 678-648-7644
Fax Number : 678-648-7479
Provider Business Practice Location Address
First Line : 3330 CHASTAIN MEADOWS PKWY NW STE 200
Second Line :
City : KENNESAW
State : GA
Zip : 30144-5881
Country : US
Telephone Number : 678-648-7644
Fax Number : 678-648-7479
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/23/2014
Last Update Date : 04/05/2023

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Directions to “ MARLET EUFRACIO ” Practice Location

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