New Life Psychology Services, LLC
Psychologist, Clinical in Lawrenceville, GA. Organization (NPI-2).
NPI number1932394855
StatusActive
Last updated in NPPESSep 13, 2007
Details
- NPI
- 1932394855
- Entity type
- Organization (NPI-2)
- Legal business name
- New Life Psychology Services, LLC
- Organization subpart
- No
- Enumeration date
- Sep 13, 2007
- Last updated
- Sep 13, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | PSY002875 | GA | Yes |
Practice location
1805 Herrington RdBuilding 2
Lawrenceville, GA 30043-7987
Phone 770-962-1944
Mailing address
1805 Herrington RdBuilding 2
Lawrenceville, GA 30043-7987
Phone 770-962-1944
Authorized official
Marnette Bender Grall
Owner
4045181018
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