Individual
KENTOSHA CODY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
110 WALTER WAY, #765, STOCKBRIDGE, GA 30281-9533
(404) 260-1377
(404) 260-1377
Mailing address
657 MORNINGSIDE DR N, STOCKBRIDGE, GA 30281-2354
(678) 760-5940
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
APC003564
GA
Other
Enumeration date
08/18/2014
Last updated
12/30/2015
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