| Doctor Name: | MS. M KATHERINE COOLIDGE |
| NPI Number: | 1013055094 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | CSW001574 |
| Business Practice Address: | 1213 Cherry Ln Canton, GA - 301146812 |
| Business Phone Number: | 6784946690 |
| Business Fax Number: | 6784949622 |
| Mailing Address: | 1213 Cherry Ln, CANTON |
| State: | GA |
| Postal Code: | 301146812 |
| Phone Number: | 6784946690 |
| Fax Number: | 6784949622 |
| NPI Enumeration Date: | 02/02/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | CSW001574 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |