Individual
OLIVIA GUPTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
708 W TAYLOR ST, GRIFFIN, GA 30223-2720
(678) 588-2119
Mailing address
1321 WHITLOCK RIDGE DR SW, MARIETTA, GA 30064-5417
(678) 938-6886
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY004587
GA
Other
Enumeration date
03/31/2022
Last updated
03/31/2022
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