Provider Demographics
NPI:1225792617
Name:FROZI ANTUNES, TAIS FROZI (ABT)
Entity Type:Individual
Prefix:MRS
First Name:TAIS
Middle Name:FROZI
Last Name:FROZI ANTUNES
Suffix:
Gender:F
Credentials:ABT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 VENUE WAY APT 8311
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-4561
Mailing Address - Country:US
Mailing Address - Phone:404-863-5484
Mailing Address - Fax:
Practice Address - Street 1:7360 MCGINNIS FERRY RD STE 100
Practice Address - Street 2:
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30024-6603
Practice Address - Country:US
Practice Address - Phone:866-523-4268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-22
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician