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General NPI Number Information
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NPI Number | 1235464561
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Entity Type | Individual
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Provider Name | REDA COSTON LMP, D.SC, PSYD/PH.D
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Gender | Female
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Dates
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Enumeration Date | 10/05/2009
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 2480 WINDY HILL RD SE SUITE 206
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City | MARIETTA
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State | GA
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Zip | 30067-8644
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Country | US
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Telephone | 855-525-1011
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Fax | 770-953-0074
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Provider Business Mailing Address
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Address Line | 2480 WINDY HILL RD SE SUITE 206
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City | MARIETTA
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State | GA
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Zip | 30067-8644
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Country | US
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Telephone | 855-525-1011
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Fax | 770-953-0074
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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 | 2083T0002X
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Taxonomy Name | Medical Toxicology (Preventive Medicine) Physician
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License Number | GMBH14112013
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License Number State | ZZ
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Taxonomy #2
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number | GA30080992
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number | PS-000294
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | 43963310
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License Number State | TX
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Taxonomy #5
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Taxonomy Code | 103TB0200X
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Taxonomy Name | Cognitive & Behavioral Psychologist
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License Number | GADLRV41529
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License Number State | NY
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Taxonomy #6
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number | S5D4Q2Q4
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License Number State | KS
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Taxonomy #7
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 300800992
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License Number State | CA
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Taxonomy #8
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number | G3D8D6T5
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License Number State | GA
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Taxonomy #9
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Taxonomy Code | 376K00000X
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Taxonomy Name | Nurse's Aide
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License Number | CN0028882028
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License Number State | GA
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Taxonomy #10
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number | NALMCC2014239P
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License Number State | NV
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Taxonomy #11
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | RYU-2012-11-35324
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License Number State | ZZ
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