=====================================================
General NPI Number Information
=====================================================
NPI Number | 1346053816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CURIOUS LEADERSHIP INSTITUTE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2025
-----------------------------------------------------
Last Update Date | 01/29/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1300 RIDENOUR BLVD NW SUITE #100
-----------------------------------------------------
City | CANISTEL
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30152
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-855-6887
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1414 BENBROOKE RDG NW
-----------------------------------------------------
City | ACWORTH
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30101-3547
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-855-6887
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | FOUNDER
-----------------------------------------------------
Name | CLAUDIA COKER
-----------------------------------------------------
Credential | PH.D.
-----------------------------------------------------
Telephone | 240-855-8887
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261Q00000X
-----------------------------------------------------
Taxonomy Name | Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 261QC1800X
-----------------------------------------------------
Taxonomy Name | Corporate Health Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------