Provider Demographics
NPI:1376649467
Name:CELANO, MARIANNE (PHD)
Entity Type:Individual
Prefix:
First Name:MARIANNE
Middle Name:
Last Name:CELANO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:THE EMORY CLINIC DEPARTMENT OF PSYCHIATRY
Mailing Address - Street 2:1365 CLIFTON ROAD, SUITE B-6100
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-0001
Mailing Address - Country:US
Mailing Address - Phone:404-778-5526
Mailing Address - Fax:404-778-4655
Practice Address - Street 1:THE EMORY CLINIC DEPARTMENT OF PSYCHIATRY
Practice Address - Street 2:1365 CLIFTON ROAD, SUITE B-6100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-0001
Practice Address - Country:US
Practice Address - Phone:404-778-5526
Practice Address - Fax:404-778-4655
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA1369103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA4618Medicare UPIN