NPI age
19 years
Enumerated 2007-04-17
Across 1678 active psychiatry & neurology providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 00553253A | |
| 01 (GA) | 36716 | STATE LICENSE NUMBER |
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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