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NPI Code Detail

MEDICARE: TAMAIGO BONITA EVELYN WILLIAMS

MEDICARE: TAMAIGO BONITA EVELYN WILLIAMS
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1174415277
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAMAIGO BONITA EVELYN WILLIAMS
Provider Business Mailing Address
First Line : PO BOX 740780
Second Line :
City : ATLANTA
State : GA
Zip : 30374-0780
Country : US
Telephone Number : 855-223-7123
Fax Number :
Provider Business Practice Location Address
First Line : 8008 E ARAPAHOE CT STE 110
Second Line :
City : CENTENNIAL
State : CO
Zip : 80112-6839
Country : US
Telephone Number : 855-223-7123
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2025
Last Update Date : 04/20/2026

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