MEDICARE: JOANNA ORREGO

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
1	101YM0800X	Mental Health Counselor	MH12019	FL
2	101YP2500X	Professional Counselor	LPC007580	GA

General Provider Information

NPI Number	:	1124440938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA ORREGO

Provider Business Mailing Address
First Line	:	366 POWDER SPRINGS ST
Second Line	:	SUITE 212
City	:	MARIETTA
State	:	GA
Zip	:	30064-3424
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	366 POWDER SPRINGS ST
Second Line	:	SUITE 212
City	:	MARIETTA
State	:	GA
Zip	:	30064-3424
Country	:	US
Telephone Number	:	786-282-0006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2014
Last Update Date	:	01/14/2014

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Directions to “ JOANNA ORREGO ” Practice Location

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