Individual
DR. DENELLA LAZENBY AUSBORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
4500 HUGH HOWELL RD, SUITE 740, TUCKER, GA 30084-4723
(770) 938-4616
(770) 938-4615
Mailing address
4500 HUGH HOWELL RD, SUITE 740, TUCKER, GA 30084-4723
(770) 938-4616
(770) 938-4615
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2469
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001346
BLUECROSS BLUESHIELD OF G
GA
05
—
00891151A
—
GA
01
—
01000297
AMERIGROUP
GA
01
—
2441599995-02
MAGELLAN
GA
01
—
2678878
MAGELLAN
GA
01
—
279069000
MAGELLAN
GA
01
—
33-1078488
NORTHLAKE MEDICAL RESEARC
GA
01
—
6134630
UNITED BEHAVIORAL HEALTH
GA
01
—
7066282
AETNA, EL PASO
GA
01
—
744015
AETNA
GA
Enumeration date
01/19/2007
Last updated
09/02/2009
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