Individual
ANN C COCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW, LCSW, CMH
Contact information
Practice address
1790 CENTURY BLVD NE, SUITE A, ATLANTA, GA 30345-3322
(404) 931-7722
Mailing address
615 AVERY ST, DECATUR, GA 30030-3812
(404) 373-5950
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
001793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00697298A
—
GA
Enumeration date
05/27/2007
Last updated
07/08/2007
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