Provider Demographics
NPI:1164767893
Name:KRYLOWSKI, BEATRICE MORENO (MS, LPC)
Entity Type:Individual
Prefix:MRS
First Name:BEATRICE
Middle Name:MORENO
Last Name:KRYLOWSKI
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 AVONLEA PARK PL
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-3782
Mailing Address - Country:US
Mailing Address - Phone:404-423-2367
Mailing Address - Fax:
Practice Address - Street 1:327 DAHLONEGA ST STE B1801
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8217
Practice Address - Country:US
Practice Address - Phone:770-302-3651
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-06
Last Update Date:2019-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC008010101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional