Individual
KIRK N JAMGOTCHIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ICADC
Contact information
Practice address
113 - B NEWNAN STREET, CARROLLTON, GA 30117
(770) 214-5066
(770) 214-5067
Mailing address
142 DEERFIELD LN, CARROLLTON, GA 30116-5010
(770) 838-1420
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
ICADC 24574
CA
Other
Enumeration date
12/14/2006
Last updated
07/08/2007
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