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NPI Code Detail

MEDICARE: MRS. DIAMOND LOVE-TATE RBT

MEDICARE: MRS. DIAMOND LOVE-TATE RBT
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 TechnicianRBT-21-169801GA

General Provider Information

NPI Number : 1902486145
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIAMOND LOVE-TATE RBT
Provider Business Mailing Address
First Line : 4000 SMITHTOWN RD
Second Line :
City : SUWANEE
State : GA
Zip : 30024-6559
Country : US
Telephone Number : 470-665-6006
Fax Number :
Provider Business Practice Location Address
First Line : 4000 SMITHTOWN RD
Second Line :
City : SUWANEE
State : GA
Zip : 30024-6559
Country : US
Telephone Number : 470-665-6006
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2021
Last Update Date : 04/21/2026

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Directions to “ MRS. DIAMOND LOVE-TATE RBT” Practice Location

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