MEDICARE: MARIA E GUILHAMELOU

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

General Provider Information

NPI Number	:	1861253478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA E GUILHAMELOU

Provider Business Mailing Address
First Line	:	1405 INVERNESS FOREST DR
Second Line	:
City	:	LUGOFF
State	:	SC
Zip	:	29078-9221
Country	:	US
Telephone Number	:	803-236-3358
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 INVERNESS FOREST DR
Second Line	:
City	:	LUGOFF
State	:	SC
Zip	:	29078-9221
Country	:	US
Telephone Number	:	803-236-3358
Fax Number	:

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

Provider Enumeration Date	:	01/22/2024
Last Update Date	:	01/22/2024

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Directions to “ MARIA E GUILHAMELOU ” Practice Location

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