Organization
SOUTH GEORGIA PSYCHOLOGICAL SERVICES PC
Active
Organization
SOUTH GEORGIA PSYCHOLOGICAL SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY L OGLETREE PH.D. (PSYCHOLOGIST)
(912) 554-9989
Entity
Organization
Contact information
Practice address
104 DUNKIRK LN, BRUNSWICK, GA 31523-6379
(912) 554-9989
(912) 554-3399
Mailing address
104 DUNKIRK LN, BRUNSWICK, GA 31523-6379
(912) 554-9989
(912) 554-3399
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001903
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000528514A
—
GA
Enumeration date
10/26/2010
Last updated
10/26/2010
Update your record
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