NPI age
19 years
Enumerated 2007-01-10
Across 196 active psychiatry & neurology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (LA) | 1753408 | |
| 05 (TX) | 122226703 | |
| 01 (TX) | H5122 | TX STATE LICENSE |
Part of a multi-provider practice. 3 other active providers share this practice address in NPPES.
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