Individual
REGINALD COPELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.DIV., LCC., M.ED
Contact information
Practice address
412 FORT ST NE, MARIETTA, GA 30060-1777
(562) 618-0877
Mailing address
412 FORT ST NE, MARIETTA, GA 30060-1777
(562) 618-0877
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
09/20/2016
Last updated
09/20/2016
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