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Individual

DR. LISA WELCH TALLANT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSYD

Contact information

Practice address
1532 DUNWOODY VILLAGE PKWY, SUITE 210, DUNWOODY, GA 30338-4136
(404) 578-6543
Mailing address
1673 WELLSHIRE LN, DUNWOODY, GA 30338-3421
(678) 587-0641
(678) 587-0641

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002416
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00968272A
GA
Enumeration date
10/24/2006
Last updated
07/23/2013
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