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NPI Profile for COWENDA S JEFFERSON in HOGANSVILLE, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
101YA0400X | |||
Counselor |
101Y00000X |
| NPI # | 1003911348 |
|
| Status | Active | |
| Credentials | MA LPC NCC CCAADC | |
| Entity | Individual | |
| Enumeration date | 09/13/2006 | |
| Last updated | 05/20/2019 - About 7 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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COWENDA S JEFFERSON
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COWENDA S JEFFERSON, MA LPC NCC CCAADC