Healthcare Provider Details

I. General information

NPI: 1487564191
Provider Name (Legal Business Name): CANA COLEMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 COBB PLACE BLVD NW
KENNESAW GA
30144-3682
US

IV. Provider business mailing address

6388 TALONA RD
TALKING ROCK GA
30175-1637
US

V. Phone/Fax

Practice location:
  • Phone: 888-329-4535
  • Fax:
Mailing address:
  • Phone: 706-502-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: