| Halla-bauer Psychological Services Corporation | |
|
300 Medical Dr Suite 705 Lagrange GA 30240-4130 | |
| (706) 885-0111 | |
| (706) 885-0607 |
| Full Name | Halla-bauer Psychological Services Corporation |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 300 Medical Dr, Lagrange, Georgia |
| Authorized Official Name and Position | Heidi Ann Halla-bauer (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 7068850111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Halla-bauer Psychological Services Corporation 300 Medical Dr Suite 705 Lagrange GA 30240-4130 Ph: (706) 885-0111 | Halla-bauer Psychological Services Corporation 300 Medical Dr Suite 705 Lagrange GA 30240-4130 Ph: (706) 885-0111 |
| NPI Number | 1619110921 |
|---|---|
| Provider Enumeration Date | 04/16/2009 |
| Last Update Date | 04/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619110921 | NPI | - | NPPES |
| 874147128A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | PSY003092 (Georgia) | Primary |
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