Provider Demographics
NPI:1194402024
Name:KUBIS, DONNA M
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:KUBIS
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 1:5002 AUDLEY LN
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CORNERS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-1787
Mailing Address - Country:US
Mailing Address - Phone:678-634-9466
Mailing Address - Fax:
Practice Address - Street 1:6230 SHILOH RD STE 140
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-8402
Practice Address - Country:US
Practice Address - Phone:770-877-2324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health