Provider Demographics
NPI:1003424953
Name:MUNOZ, MARIA ROSA ACOSTA
Entity Type:Individual
Prefix:
First Name:MARIA ROSA
Middle Name:ACOSTA
Last Name:MUNOZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:981 COURTENAY DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3329
Mailing Address - Country:US
Mailing Address - Phone:404-272-5992
Mailing Address - Fax:
Practice Address - Street 1:4411 SUWANEE DAM RD STE 720
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-8708
Practice Address - Country:US
Practice Address - Phone:678-993-8494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health