Individual
DR. TINA MARIE CAUDILL
Active
Individual
DR. TINA MARIE CAUDILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002899
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112025855D
—
GA
05
—
112025855E
—
GA
05
—
112025855F
—
GA
Enumeration date
11/10/2005
Last updated
08/24/2009
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