Individual
DR. HAROLD LAMAR GARDNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
3990 COLUMBIA RD, MARTINEZ, GA 30907-2220
(706) 860-1122
(706) 860-3839
Mailing address
PO BOX 211008, AUGUSTA, GA 30917-1008
(706) 860-1122
(706) 860-3839
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY000488
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00083663A
—
GA
Enumeration date
01/09/2007
Last updated
07/08/2007
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