NPI age
19 years
Enumerated 2006-07-10
Across 1487 active psychologist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | XXXXX9255 | TRICARE |
| 01 (GA) | 281450LO | BCBS |
| 05 (GA) | 000463724B |
Part of a multi-provider practice. 11 other active providers share this practice address in NPPES.
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