Individual
ANGELLA COUSINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 W TAYLOR ST, GRIFFIN, GA 30223-2720
(770) 833-2851
Mailing address
504 WALDEN RUN PL, MCDONOUGH, GA 30253-7011
(678) 651-4495
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/10/2013
Last updated
12/08/2015
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