Provider Demographics
NPI:1356064703
Name:PAULIC, MARIE GUENAELLE
Entity type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:GUENAELLE
Last Name:PAULIC
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 1:2805 MORNINGTON DR NW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-1272
Mailing Address - Country:US
Mailing Address - Phone:470-662-7186
Mailing Address - Fax:
Practice Address - Street 1:2805 MORNINGTON DR NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30327-1272
Practice Address - Country:US
Practice Address - Phone:470-662-7186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor