Individual
CARISSA BALDERAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
5003 FIVE OAKS WAY, TUCKER, GA 30084-8166
(562) 652-3744
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004175
GA
Other
Enumeration date
04/24/2018
Last updated
04/24/2018
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