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General NPI Number Information
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NPI Number | 1992576334
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Entity Type | Individual
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Provider Name | DR. NESHIKA L CONEY-DEVINE
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Gender | Female
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 4210 COLUMBIA RD STE 11B
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City | MARTINEZ
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State | GA
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Zip | 30907-0443
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Country | US
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Telephone | 706-364-6576
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Fax |
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Provider Business Mailing Address
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Address Line | 2020 CLARKSTON DR
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City | AUGUSTA
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State | GA
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Zip | 30909-0610
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Country | US
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Telephone | 706-825-1781
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | APC009461
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License Number State | GA
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