Tenkapowom, Kowanda

Tenkapowom, Kowanda is an sole proprietor health care provider with primary practice located at 3421 Mike Padgett Hwy , Augusta GA 30906-3815. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities. Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is her primary health care specialty. Tenkapowom, Kowanda can be contacted via phone (706) 432-7893.

Contact Information

Primary practice address
3421 Mike Padgett Hwy Augusta GA 30906-3815
Phone: (706) 432-7893
Fax: (706) 432-3780
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Retardation & Developmental Disabilities 103TM1800X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X

Profile Details

NPI number 1316212749
LBN Legal business name Tenkapowom, Kowanda
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 19th, 2012
Last updated Mar 19th, 2012 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1316212749 NPPES
Georgia MEDICAID 000606317B

Popular Providers