Doctor Name: | DR. JOHN KENT |
NPI Number: | 1245371376 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHD |
License Number: | PSY002344 |
Business Practice Address: | 5468 Sugar Mill Dr Flowery Branch, GA - 305425162 |
Business Phone Number: | 7709653127 |
Business Fax Number: | |
Mailing Address: | 5468 Sugar Mill Dr, FLOWERY BRANCH |
State: | GA |
Postal Code: | 305425162 |
Phone Number: | 7709653127 |
Fax Number: | |
NPI Enumeration Date: | 02/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC1900X |
License Number: | PSY002344 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Counseling |
Taxonomy Definition: |