Provider Demographics
NPI:1235412560
Name:GUEVARA, GIULLIANA
Entity Type:Individual
Prefix:
First Name:GIULLIANA
Middle Name:
Last Name:GUEVARA
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 1:5608 AVONLEY CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-7298
Mailing Address - Country:US
Mailing Address - Phone:770-815-2466
Mailing Address - Fax:
Practice Address - Street 1:5608 AVONLEY CREEK DR
Practice Address - Street 2:
Practice Address - City:SUGAR HILL
Practice Address - State:GA
Practice Address - Zip Code:30518-7298
Practice Address - Country:US
Practice Address - Phone:770-815-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator