Provider Demographics
NPI:1891221784
Name:COHEN, SIMONA
Entity Type:Individual
Prefix:MRS
First Name:SIMONA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4045 ORCHARD RD SE
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-4902
Mailing Address - Country:US
Mailing Address - Phone:770-293-1950
Mailing Address - Fax:770-293-1955
Practice Address - Street 1:4045 ORCHARD RD SE
Practice Address - Street 2:SUITE 110
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30080-4902
Practice Address - Country:US
Practice Address - Phone:770-293-1950
Practice Address - Fax:770-293-1955
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional