Individual
MRS. COWENDA SHAVONNE JEFFERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA LPC NCC CCAADC
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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