Individual
DINA P. O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2191
(706) 721-4920
Mailing address
1499 WALTON WAY, STE 1400, AUGUSTA, GA 30901-2650
(706) 828-6410
(706) 722-5187
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
PSY002668
GA
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PY61072498
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
680820190A
—
GA
05
—
PS0364
—
SC
Enumeration date
09/22/2006
Last updated
04/28/2021
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