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Individual

DR. TONI L MASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
1361 JENNINGS MILL RD, SUITE 201, BOGART, GA 30622-2579
(706) 316-1908
(706) 316-2062
Mailing address
1361 JENNINGS MILL RD, SUITE 201, BOGART, GA 30622-2579
(706) 316-1908
(706) 316-2062

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
2674
GA
103TB0200X
Cognitive & Behavioral Psychologist
2674
GA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
2674
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10034544
AMERIGROUP
GA
Enumeration date
11/14/2006
Last updated
09/20/2007
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