NPI age
17 years
Enumerated 2008-10-16
Across 1114 active psychologist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | PSY001777 | STATE LICENSE |
| 05 (GA) | 000566299B |
Part of a multi-provider practice. 18 other active providers share this practice address in NPPES.
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