Provider Demographics
NPI:1699837559
Name:COHEN, JUDITH C (RN)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:C
Last Name:COHEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8201 HAZELBRAND RD NE
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:GA
Mailing Address - Zip Code:30014-1510
Mailing Address - Country:US
Mailing Address - Phone:770-787-3977
Mailing Address - Fax:770-784-3022
Practice Address - Street 1:8201 HAZELBRAND RD NE
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-1510
Practice Address - Country:US
Practice Address - Phone:770-787-3977
Practice Address - Fax:770-784-3022
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN033650251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health