Provider Demographics
NPI:1063226876
Name:IGOCHE, MARIA
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:IGOCHE
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 1:1860 SANDY PLAINS RD STE 204
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30066-7864
Mailing Address - Country:US
Mailing Address - Phone:404-558-6332
Mailing Address - Fax:
Practice Address - Street 1:1860 SANDY PLAINS RD STE 204
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30066-7864
Practice Address - Country:US
Practice Address - Phone:404-558-6332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care