Individual
KAITLIN BAKER PROCTOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1920 BRIARCLIFF RD NE, ATLANTA, GA 30329-4010
(404) 785-9350
Mailing address
245 E TRINITY PL UNIT 1425, DECATUR, GA 30030-3494
(205) 999-2298
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY004209
GA
Other
Enumeration date
08/07/2018
Last updated
08/07/2018
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