Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | GADLRV41529 | NY |
N | 175F00000X | Naturopath | 43963310 | TX |
NPI | 1235464561 |
---|---|
Provider Name | Dr. Reda Coston |
First Address | Marietta, GA 30067-8644 |
Second Address | Marietta, GA 30067-8644 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2009 |
Last Update Date | 18/06/2015 |