Organization
R LITTLE ENTERPRISES INC
Active
Organization
R LITTLE ENTERPRISES INC
Active
Other names
CONNIE STAPLETON PHD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CONNIE STAPLETON PHD (PSYCHOLOGIST)
(706) 364-5228
Entity
Organization
Contact information
Practice address
2915 PROFESSIONAL PKWY, SUITE C, AUGUSTA, GA 30907-6521
(706) 364-5228
(706) 364-5229
Mailing address
2915 PROFESSIONAL PKWY, SUITE C, AUGUSTA, GA 30907-6521
(706) 364-5228
(706) 364-5229
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2412
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
497373
VALUE OPTIONS
GA
01
—
52821111-001
BCBS ID#
GA
Enumeration date
06/10/2006
Last updated
08/22/2020
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