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Individual

DR. NANCY L OGLETREE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
421 ATLANTIC DR, ST SIMONS ISLAND, GA 31522-1373
(912) 638-9687
(912) 638-9514
Mailing address
421 ATLANTIC DR, ST SIMONS ISLAND, GA 31522-1373
(912) 638-9687
(912) 638-9514

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001903
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00528514A
GA
Enumeration date
11/05/2006
Last updated
07/09/2007
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