Individual
LARRY JENKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CACII, NCACII, B.S.
Contact information
Practice address
116 PEACHTREE CT STE A, PEACHTREE CITY, GA 30269-4800
(770) 719-1746
(770) 716-2368
Mailing address
41 FARMER ST STE 101, NEWNAN, GA 30263-8672
(770) 683-3150
(770) 683-3151
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1684CACII
GA
Other
Enumeration date
09/29/2018
Last updated
03/14/2022
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