Healthcare Provider Details

I. General information

NPI: 1346053816
Provider Name (Legal Business Name): CURIOUS LEADERSHIP INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2025
Last Update Date: 01/29/2025
Certification Date: 12/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 RIDENOUR BLVD NW SUITE #100
CANISTEL GA
30152
US

IV. Provider business mailing address

1414 BENBROOKE RDG NW
ACWORTH GA
30101-3547
US

V. Phone/Fax

Practice location:
  • Phone: 240-855-6887
  • Fax:
Mailing address:
  • Phone: 240-855-6887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QC1800X
TaxonomyCorporate Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAUDIA COKER
Title or Position: FOUNDER
Credential: PH.D.
Phone: 240-855-8887