Individual
JESSICA KOALENZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NCC, APC
Contact information
Practice address
107 ENTERPRISE PATH, SUITE 305-2, HIRAM, GA 30141
(678) 896-8959
Mailing address
107 ENTERPRISE PATH STE 305-2, HIRAM, GA 30141-2689
(678) 896-8959
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
GA
Other
Enumeration date
07/19/2017
Last updated
07/21/2022
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