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NPI Code Detail

MEDICARE: ALEJANDRA VEGA

MEDICARE:   ALEJANDRA  VEGA
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 : 1760110548
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEJANDRA VEGA
Provider Business Mailing Address
First Line : 4167 CLARK HILL CT
Second Line :
City : BUFORD
State : GA
Zip : 30519-3719
Country : US
Telephone Number : 404-839-1840
Fax Number :
Provider Business Practice Location Address
First Line : 1130 HURRICANE SHOALS RD NE STE 1800
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30043-4849
Country : US
Telephone Number : 888-329-4535
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/10/2022
Last Update Date : 08/10/2022

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Directions to “ ALEJANDRA VEGA ” Practice Location

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