Provider Demographics
NPI:1346368099
Name:FLOYD, MARNITA (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARNITA
Middle Name:
Last Name:FLOYD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4050 HILLCREST VIEW CT
Mailing Address - Street 2:MEADOWBROOKE SUBDIVISION
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6496
Mailing Address - Country:US
Mailing Address - Phone:404-276-9389
Mailing Address - Fax:678-546-2846
Practice Address - Street 1:2250 SATELLITE BLVD
Practice Address - Street 2:SUITE #175
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-4906
Practice Address - Country:US
Practice Address - Phone:404-276-9389
Practice Address - Fax:678-546-2846
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY002515103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical