Individual
KACIE DENTLEEGRAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2298 BROCKETT RD, TUCKER, GA 30084-4414
(706) 425-8900
(706) 425-8600
Mailing address
1 HUNTINGTON RD STE 703, ATHENS, GA 30606-7214
(706) 425-8900
(706) 425-8600
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
APC010197
GA
Other
Enumeration date
06/11/2026
Last updated
06/11/2026
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