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Individual

DR. LANINA ELIZABETH MOMPREMIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
5011 OAK TREE LN, STONE MTN, GA 30087-3289
(240) 339-3518
Mailing address
1227 ROCKBRIDGE RD. SW, STE 208, BOX 364, STONE MOUTAIN, GA 30087
(240) 339-3518

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
05139
MD
103TC0700X
Clinical Psychologist
08100004543
VA
103TC0700X
Clinical Psychologist
Primary
PSY1000830
DC

Other

Enumeration date
05/31/2019
Last updated
05/31/2019
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