Individual
KENNETH COLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
120 E TRINITY PL, DECATUR, GA 30030-3302
(404) 378-2300
Mailing address
120 E TRINITY PL, DECATUR, GA 30030-3302
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC008851
GA
106H00000X
Marriage & Family Therapist
MFT001469
GA
Other
Enumeration date
02/13/2017
Last updated
02/13/2017
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