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Individual

MICHAEL KANNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
41 WOODSTOCK RD, ROSWELL, GA 30075-3559
(770) 580-0036
Mailing address
41 WOODSTOCK RD, ROSWELL, GA 30075-3559
(770) 580-0036

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LPC013026
133VN1201X
Obesity and Weight Management Nutrition Registered Dietitian
LD004005
GA

Other

Enumeration date
11/06/2019
Last updated
07/29/2024
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