NPI age
19 years
Enumerated 2007-01-11
Across 1114 active psychologist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000577596A | |
| 01 | 600006850 | MAGELLAN |
| 01 | 10058276 | AMERIGROUP |
Part of a multi-provider practice. 5 other active providers share this practice address in NPPES.
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