Abraham, Mary Theresa

Abraham, Mary Theresa is an individual health care provider with primary practice located at 707 Whitlock Ave Sw Suite H-10, Marietta GA 30064-3000. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Abraham, Mary Theresa can be contacted via phone (770) 591-7518.

Contact Information

Primary practice address
707 Whitlock Ave Sw Suite H-10 Marietta GA 30064-3000
Phone: (770) 591-7518
Fax: (678) 498-2843
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 003709 Georgia

Profile Details

NPI number 1427124593
LBN Legal business name Abraham, Mary Theresa
Credentials MS LPC NCC MAC CPCS
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2006
Last updated Apr 9th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427124593 NPPES
Georgia Other 10063297 AMERIGROUP
Georgia Other 5732533 AMERIGROUP
Georgia MEDICAID 129577652A AMERIGROUP
Georgia Other 726881000 AMERIGROUP
Georgia Other 582262349 AMERIGROUP
Georgia Other 10063295 AMERIGROUP
Georgia Other 1427124593 AMERIGROUP

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