MEDICARE: MRS. BEATRICE MORENO KRYLOWSKI MS, LPC

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	101YP2500X	Professional Counselor	LPC008010	GA

General Provider Information

NPI Number	:	1164767893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BEATRICE MORENO KRYLOWSKI MS, LPC

Provider Business Mailing Address
First Line	:	102 AVONLEA PARK PL
Second Line	:
City	:	SUWANEE
State	:	GA
Zip	:	30024-3782
Country	:	US
Telephone Number	:	404-423-2367
Fax Number	:

Provider Business Practice Location Address
First Line	:	327 DAHLONEGA ST STE B1801
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30040-8217
Country	:	US
Telephone Number	:	770-302-3651
Fax Number	:

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

Provider Enumeration Date	:	12/06/2012
Last Update Date	:	12/12/2019

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