Provider Demographics
NPI:1730598939
Name:ROONEY, MAE WILEEN MERCADO (PT)
Entity type:Individual
Prefix:
First Name:MAE WILEEN
Middle Name:MERCADO
Last Name:ROONEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2496 NORWOOD PARK XING
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30340-1856
Mailing Address - Country:US
Mailing Address - Phone:863-602-0823
Mailing Address - Fax:
Practice Address - Street 1:2496 NORWOOD PARK XING
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30340-1856
Practice Address - Country:US
Practice Address - Phone:863-602-0823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-13
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011583225100000X
GAPT011583225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist