Individual
DR. MARY ANN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYCHOLOGIST
Contact information
Practice address
1549 COLEMAN AVE, MACON, GA 31201-1517
(478) 361-1848
Mailing address
3495 RIDGE AVE, MACON, GA 31204-1860
(478) 477-4399
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
00856
GA
Other
Enumeration date
12/15/2006
Last updated
07/09/2007
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