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Individual

DR. JOAN ALLISON LANUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PSY.D.

Contact information

Practice address
3626 VINEVILLE AVE, MACON, GA 31204-1853
(478) 474-4073
(478) 474-4074
Mailing address
3027 GENERAL LEE RD, MACON, GA 31204-1517
(478) 474-4073
(478) 474-4074

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002796
GA

Other

Enumeration date
12/18/2006
Last updated
07/08/2007
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