MEDICARE: MRS. FRANCIA DACOSTA COUNSELOR M.A

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	101Y00000X	Counselor	03235030	GA

General Provider Information

NPI Number	:	1902595424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FRANCIA DACOSTA COUNSELOR M.A

Provider Business Mailing Address
First Line	:	4644 POWDER SPRINGS DALLAS RD UNIT 484
Second Line	:
City	:	POWDER SPRINGS
State	:	GA
Zip	:	30127-7704
Country	:	US
Telephone Number	:	770-714-5276
Fax Number	:

Provider Business Practice Location Address
First Line	:	2416 WOOD MEADOWS DR SW
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-4471
Country	:	US
Telephone Number	:	770-714-5276
Fax Number	:

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

Provider Enumeration Date	:	05/01/2023
Last Update Date	:	05/01/2023

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