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Individual

MS. LATHONIA ADEKUNLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2300 HERODIAN WAY SE, SMYRNA, GA 30080
(770) 309-1658
Mailing address
1620 OLDE SPRING TRL, LITHIA SPGS, GA 30122-2749
(770) 309-1658

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YP2500X
Professional Counselor
Primary
GA
171M00000X
Case Manager/Care Coordinator
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1649746371
GA
Enumeration date
10/20/2018
Last updated
01/26/2022
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