Active NPI
Mariam B Kidane
- Behavior Technician
- Duluth, GA
National Provider Identifier
1396659165
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- RBT-25-447834
- Practice address
- 4114 Amber Trail
Duluth, GA 30096 - Phone
- (855) 832-6727
- NPI assigned
- Sep 29, 2026
- Last updated
- Sep 29, 2026
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | RBT-25-447834 | GA | Primary |
Addresses
Primary practice location
4114 Amber Trail
Duluth, GA 30096
Mailing address
7108 South Kanner Hwy
Stuart, FL 34997-7462
Phone (855) 832-6727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1790640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1790640000000",
"number": "1396659165",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7108 SOUTH KANNER HWY",
"city": "STUART",
"state": "FL",
"postal_code": "349977462",
"telephone_number": "855-832-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4114 AMBER TRAIL",
"city": "DULUTH",
"state": "GA",
"postal_code": "30096",
"telephone_number": "855-832-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIDANE",
"first_name": "MARIAM",
"middle_name": "B",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-09-29",
"last_updated": "2026-09-29",
"certification_date": "2026-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "GA",
"license": "RBT-25-447834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Duluth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.