MEDICARE: DARCY RONDON COLMENARES BCBA

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1467027540
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARCY RONDON COLMENARES BCBA

Provider Business Mailing Address
First Line	:	3775 VENTURE DR STE M101
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-5217
Country	:	US
Telephone Number	:	470-610-4222
Fax Number	:

Provider Business Practice Location Address
First Line	:	3775 VENTURE DR STE M101
Second Line	:
City	:	DULUTH
State	:	GA
Zip	:	30096-5217
Country	:	US
Telephone Number	:	470-610-4222
Fax Number	:

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

Provider Enumeration Date	:	05/21/2021
Last Update Date	:	11/01/2023

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