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General NPI Number Information
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NPI Number | 1417338013
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Entity Type | Individual
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Provider Name | PETER K ADZUDZOR MA
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Gender | Male
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Dates
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Enumeration Date | 06/09/2015
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Last Update Date | 06/09/2015
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Provider Practice Location Address
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Address Line | 127 CHURCH ST NE SUITE 350
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City | MARIETTA
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State | GA
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Zip | 30060-8637
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Country | US
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Telephone | 404-828-0087
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Fax |
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Provider Business Mailing Address
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Address Line | 3540 GARDEN MIST CIR
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City | AUBURN
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State | GA
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Zip | 30011-2375
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Country | US
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Telephone | 678-201-8859
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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 |
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License Number State |
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