Organization
JAL PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN ALLISON LANUM PSY.D. (PSYCHOLOGIST)
(478) 474-4073
Entity
Organization
Contact information
Practice address
3626 VINEVILLE AVE, MACON, GA 31204-1853
(478) 474-4073
(478) 474-4074
Mailing address
3626 VINEVILLE AVE, MACON, GA 31204-1853
(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
08/22/2020
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