Individual
TRACI ANNE PAULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
996 COLEY STATION RD, COCHRAN, GA 31014-5548
(478) 230-4348
Mailing address
996 COLEY STATION RD, COCHRAN, GA 31014-5548
(478) 230-4348
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
778131
GA
103TS0200X
School Psychologist
778131
TN
Other
Enumeration date
12/04/2024
Last updated
12/04/2024
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