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Individual

LAURA MCMASTER DEPAOLA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
615 BARLOW ST, AMERICUS, GA 31709-4206
(229) 928-9887
(229) 928-9461
Mailing address
615 BARLOW STREET, AMERICUS, GA 31709

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY001831
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00614886D
GA
Enumeration date
03/23/2006
Last updated
07/08/2007
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