Individual
LAUREN POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
1001 WEATHERSTONE PKWY STE 430, WOODSTOCK, GA 30188-4495
(770) 592-0150
Mailing address
306 GLEN MILL CT, WOODSTOCK, GA 30188-6117
(941) 539-5833
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
4253
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2015
Last updated
02/01/2022
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