Individual
GILBERTE BASTIEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5975 PARKWAY NORTH BLVD STE D, CUMMING, GA 30040-8255
(404) 388-3909
Mailing address
4928 LONGVIEW RUN, DECATUR, GA 30035-4096
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004074
GA
Other
Enumeration date
06/20/2018
Last updated
06/20/2018
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