Marie Ann Church

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

RBT-24-356254 Issued in GA

Practice address

579 Potomac Dr
Tiger, GA 30576-2731

Phone

(678) 986-0817

NPI assigned

Jul 9, 2024

Last updated

Jul 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1720483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1851138895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "579 POTOMAC DR",
            "city": "TIGER",
            "state": "GA",
            "postal_code": "305762731",
            "telephone_number": "678-986-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "579 POTOMAC DR",
            "city": "TIGER",
            "state": "GA",
            "postal_code": "305762731",
            "telephone_number": "678-986-0817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "MARIE",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-09",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "GA",
            "license": "RBT-24-356254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piper L Coffey, LCSW
• Megan Fonclara
• Shanda Danielle Henry, MS, LAT, ATC
• Elaina Noel Bristol Hinton, LMSW
• Andrea Curran Howell, FNP

• Behavior Analyst in Tiger, GA
• Providers in Tiger, GA by specialty
• Behavior Analyst in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.