MEDICARE: AMARA RAE LORENZO

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	106S00000X	Behavior Technician	RBT-25-425982

General Provider Information

NPI Number	:	1588521652
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMARA RAE LORENZO

Provider Business Mailing Address
First Line	:	3100 FIVE FORKS TRICKUM RD SW STE 203
Second Line	:
City	:	LILBURN
State	:	GA
Zip	:	30047-1887
Country	:	US
Telephone Number	:	470-485-2220
Fax Number	:	855-803-6288

Provider Business Practice Location Address
First Line	:	3100 FIVE FORKS TRICKUM RD SW STE 203
Second Line	:
City	:	LILBURN
State	:	GA
Zip	:	30047-1887
Country	:	US
Telephone Number	:	470-485-2220
Fax Number	:	855-803-6288

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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Directions to “ AMARA RAE LORENZO ” Practice Location

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