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NPI Code Detail

MEDICARE: LAGLENDA SHACOLE COBB

MEDICARE: LAGLENDA SHACOLE COBB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1245006436
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAGLENDA SHACOLE COBB
Provider Business Mailing Address
First Line : 1845 SATELLITE BLVD STE 800
Second Line :
City : DULUTH
State : GA
Zip : 30097-6286
Country : US
Telephone Number : 404-295-7941
Fax Number : 312-929-0324
Provider Business Practice Location Address
First Line : 1845 SATELLITE BLVD STE 800
Second Line :
City : DULUTH
State : GA
Zip : 30097-6286
Country : US
Telephone Number : 404-295-7941
Fax Number : 312-929-0324
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2023
Last Update Date : 11/28/2023

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Directions to “ LAGLENDA SHACOLE COBB ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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