Provider Demographics
NPI:1023171337
Name:KUSCHNITZKY, TANYA (MA ED)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:KUSCHNITZKY
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:756 TERRELL CROSSING
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067
Mailing Address - Country:US
Mailing Address - Phone:404-702-8474
Mailing Address - Fax:770-952-7565
Practice Address - Street 1:1640 POWERS FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067
Practice Address - Country:US
Practice Address - Phone:404-702-8474
Practice Address - Fax:214-324-4953
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16425101YP2500X
GA006711101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional