Individual
REBECCA S BLAKEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
5833 STEWART PKWY STE 203, DOUGLASVILLE, GA 30135-6934
(404) 310-1161
Mailing address
4643 RABUN DR, DOUGLASVILLE, GA 30135-5827
(404) 310-1161
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
002757
GA
Other
Enumeration date
08/12/2008
Last updated
07/02/2021
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