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Organization

THE MENTALITY SPA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MELANIE KENNER LMFT (OWNER)
(404) 994-9974
Entity
Organization

Contact information

Practice address
8319 OFFICE PARK DR, DOUGLASVILLE, GA 30134-6936
(404) 994-9974
(678) 306-8663
Mailing address
2389 NAVAJO TRL SW, ATLANTA, GA 30331-7059
(404) 994-9974
(678) 306-8663

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
106H00000X
Marriage & Family Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1023761996
NPI
GA
Enumeration date
10/05/2022
Last updated
10/05/2022
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