Individual
DR. JUAN CARLOS CORDERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S., M.A., PSY.D
Contact information
Practice address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(129) 435-7375
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-7375
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
002740
PR
101YP2500X
Professional Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
002740
PR
103TC0700X
Clinical Psychologist
2740
PR
Other
Enumeration date
07/15/2014
Last updated
12/21/2023
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