Individual
DR. KENWANA MICHELLE VANDERBILT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
MACON OUTPATIENT CLINIC- 5398 THOMASTON RD., SUITE B, MACON, GA 31220
(478) 476-8868
(478) 476-8161
Mailing address
MACON OUTPATIENT CLINIC- 5398 THOMASTON RD., SUITE B, MACON, GA 31220
(478) 476-8868
(478) 476-8161
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003494
GA
Other
Enumeration date
03/05/2013
Last updated
03/09/2016
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