NPI age
20 years
Enumerated 2005-08-02
Across 681 active psychiatry & neurology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (FL) | ME127689 | FL STATE LICENSE |
| 05 (GA) | 00443913D |
Solo or small practice. No other active providers share this practice address in NPPES.
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