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Individual

DR. EMILY JO ANDERSON MACKILLOP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
2400 MT. ZION PARKWAY, KAISER PERMANENTE SOUTHWOOD MEDICAL CENTER, JONESBORO, GA 30236
(770) 603-3877
Mailing address
3495 PIEDMONT ROAD, NE, NINE PIEDMONT CENTER, ATLANTA, GA 30305
(404) 364-7070

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
103TC0700X
Clinical Psychologist
Primary
PSY003221
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
631220898A
GA
Enumeration date
09/21/2008
Last updated
06/28/2011
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