Individual
DR. MIRIAM HANCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1 FREEDOM WAY, MENTAL HEALTH SERVICE LINE, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
130 FIORD DR, NORTH AUGUSTA, SC 29841-6043
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003227
GA
Other
Enumeration date
09/22/2006
Last updated
03/13/2012
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