Individual
DR. KRISTEN J AYCOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
115 HABERSHAM DR, FAYETTEVILLE, GA 30214-7353
(770) 461-9944
Mailing address
115 HABERSHAM DR., FAYETTEVILLE, GA 30214
(770) 461-9944
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY003590
GA
Other
Enumeration date
08/28/2012
Last updated
01/31/2013
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