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Individual

LINDA VITACCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
3405 MIKE PADGETT HWY, ATTENTION PATIENT ACCOUNTS, AUGUSTA, GA 30906-3815
(706) 792-7026
(706) 792-7314
Mailing address
3405 MIKE PADGETT HWY, ATTENTION PATIENT ACCOUNTS, AUGUSTA, GA 30906-3815
(706) 792-7026
(706) 792-7314

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003560
GA

Other

Enumeration date
12/04/2013
Last updated
12/04/2013
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