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NPI Code Detail

MEDICARE: AMBER LATRICE COACHMAN LPC

MEDICARE: AMBER LATRICE COACHMAN LPC
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
1101YP2500XProfessional CounselorLPC010458GA

General Provider Information

NPI Number : 1780318774
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMBER LATRICE COACHMAN LPC
Provider Business Mailing Address
First Line : 2908 MEADOW POINT DR
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-7767
Country : US
Telephone Number : 404-408-7279
Fax Number :
Provider Business Practice Location Address
First Line : 175 GWINNETT DR
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30046-8444
Country : US
Telephone Number : 678-209-2394
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2022
Last Update Date : 07/14/2022

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Directions to “ AMBER LATRICE COACHMAN LPC” Practice Location

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