MEDICARE: MARIANA MENESES MURILLO

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	1-25-86177	GA

General Provider Information

NPI Number	:	1467316562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIANA MENESES MURILLO

Provider Business Mailing Address
First Line	:	4835 MARJORIE DR
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-1352
Country	:	US
Telephone Number	:	470-422-2832
Fax Number	:

Provider Business Practice Location Address
First Line	:	12970 SR-9
Second Line	:
City	:	ALPHARETTA
State	:	GA
Zip	:	30004
Country	:	US
Telephone Number	:	678-370-9990
Fax Number	:

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

Provider Enumeration Date	:	12/12/2025
Last Update Date	:	12/12/2025

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