Individual
THERESA D LUPCHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 CROWN POINTE PKWY, SUITE 295, ATLANTA, GA 30338-7707
(866) 325-5434
(866) 325-5340
Mailing address
6300 MOSELEY DIXON RD, APT. 206N, MACON, GA 31220-8400
(866) 325-5434
(866) 325-5340
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002914
GA
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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