Provider Demographics
NPI:1548941370
Name:HOWARD, KAHDA MONIQUE
Entity type:Individual
Prefix:
First Name:KAHDA
Middle Name:MONIQUE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AM
Other - Middle Name:
Other - Last Name:RELIABLE TRANSPORTATION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LLC
Mailing Address - Street 1:2712 REYNOLDS DR
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206-4949
Mailing Address - Country:US
Mailing Address - Phone:470-891-7110
Mailing Address - Fax:
Practice Address - Street 1:2712 REYNOLDS DR
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-4949
Practice Address - Country:US
Practice Address - Phone:470-891-7110
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-25
Last Update Date:2023-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057529485343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)