Individual
KEVIN DE LA ESPADA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
122 GORDON COMMERCIAL DR STE C, LAGRANGE, GA 30240-5754
(706) 845-4045
(706) 845-4367
Mailing address
122 GORDON COMMERCIAL DR STE C, LAGRANGE, GA 30240-5754
(706) 845-4045
(706) 845-4367
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
GA
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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