Organization
HALLA-BAUER PSYCHOLOGICAL SERVICES CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI ANN HALLA-BAUER PSYD (PSYCHOLOGIST/OWNER)
(706) 885-0111
Entity
Organization
Contact information
Practice address
300 MEDICAL DR, SUITE 705, LAGRANGE, GA 30240-4130
(706) 885-0111
(706) 885-0607
Mailing address
300 MEDICAL DR, SUITE 705, LAGRANGE, GA 30240-4130
(706) 885-0111
(706) 885-0607
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY003092
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
874147128A
—
GA
Enumeration date
04/16/2009
Last updated
04/16/2009
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