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Individual

DR. MALINDA ANN DALE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
506 N JACKSON ST, THE RENAISSANCE CENTRE, ALBANY, GA 31701-2308
(229) 889-7200
(229) 889-7393
Mailing address
760 FLOWING WELL RD, LEESBURG, GA 31763-3126

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY002619
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000966985A
GA
Enumeration date
11/16/2005
Last updated
06/28/2011
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