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General NPI Number Information
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NPI Number | 1033877964
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Entity Type | Individual
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Provider Name | KATTEGUMMULA ANJALI REDDY
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Gender | Female
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1200 ALTMORE AVE STE 200
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City | ATLANTA
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State | GA
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Zip | 30342-2495
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Country | US
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Telephone | 770-389-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 103 OLD MORGANTOWN RD APT L109A
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City | BOWLING GREEN
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State | KY
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Zip | 42101-2835
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Country | US
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Telephone | 404-809-1360
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC015129
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License Number State | GA
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