| South Georgia Psychological Services Pc | |
|
104 Dunkirk Ln Brunswick GA 31523-6379 | |
| (912) 554-9989 | |
| (912) 554-3399 |
| Full Name | South Georgia Psychological Services Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 104 Dunkirk Ln, Brunswick, Georgia |
| Authorized Official Name and Position | Nancy L Ogletree (PSYCHOLOGIST) |
| Authorized Official Contact | 9125549989 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| South Georgia Psychological Services Pc 104 Dunkirk Ln Brunswick GA 31523-6379 Ph: (912) 554-9989 | South Georgia Psychological Services Pc 104 Dunkirk Ln Brunswick GA 31523-6379 Ph: (912) 554-9989 |
| NPI Number | 1083914881 |
|---|---|
| Provider Enumeration Date | 10/26/2010 |
| Last Update Date | 10/26/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083914881 | NPI | - | NPPES |
| 000528514A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY001903 (Georgia) | Primary |
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