Provider Demographics
NPI:1528563053
Name:DAYE, MARILYN CORINNA (ATC)
Entity Type:Individual
Prefix:
First Name:MARILYN
Middle Name:CORINNA
Last Name:DAYE
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 GEORGE BUSBEE PKWY NW APT 14108
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-4885
Mailing Address - Country:US
Mailing Address - Phone:912-602-2471
Mailing Address - Fax:
Practice Address - Street 1:3220 BUSBEE DR NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-3042
Practice Address - Country:US
Practice Address - Phone:470-578-2913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2018-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAT0033432255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer