Individual
MRS. COWENDA SHAVONNE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC NCC CCAADC
Contact information
Practice address
103 RENAE LN, HOGANSVILLE, GA 30230
(762) 323-9693
Mailing address
103 RENAE LN, HOGANSVILLE, GA 30230-3434
(762) 323-9693
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
229340
GA
101YA0400X
Addiction (Substance Use Disorder) Counselor
C0101
GA
101YP2500X
Professional Counselor
Primary
LPC006320
GA
Other
Enumeration date
09/13/2006
Last updated
05/20/2019
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