Mack, Kaneisha
Mack, Kaneisha is an sole proprietor health care provider with primary practice located at 122 Gordon Commercial Dr , Lagrange GA 30240-5754. She recently has only one registered license in Other Service Providers / Peer Specialist, which is considered as her primary health care specialty. Mack, Kaneisha can be contacted via phone (706) 845-4054.Contact Information
Primary practice address
122 Gordon Commercial Dr
Lagrange GA 30240-5754
Phone: (706) 845-4054
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Peer Specialist | 175T00000X |
Profile Details
| NPI number | 1952862286 |
|---|---|
| LBN Legal business name | Mack, Kaneisha |
| Credentials | CPS-WH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 28th, 2019 |
| Last updated | Mar 28th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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