Provider Demographics
NPI:1003037888
Name:KANT, CAROLE A. A (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLE A.
Middle Name:A
Last Name:KANT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 FERNWOOD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30319-3031
Mailing Address - Country:US
Mailing Address - Phone:404-240-0243
Mailing Address - Fax:
Practice Address - Street 1:1340 FERNWOOD CIRCLE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30319-3031
Practice Address - Country:US
Practice Address - Phone:404-240-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0001948103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist