Provider Demographics
NPI:1932919628
Name:COKER, KIRSTEN ANNE
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:ANNE
Last Name:COKER
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 1:3418 HAMPTON RD SE
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30721-6464
Mailing Address - Country:US
Mailing Address - Phone:706-463-8031
Mailing Address - Fax:
Practice Address - Street 1:3418 HAMPTON RD SE
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30721-6464
Practice Address - Country:US
Practice Address - Phone:706-463-8031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health