| Mikala A Legako Psyd Psych Svc | |
|
83 Bailey Dr Newnan GA 30263-2913 | |
| (678) 314-7469 | |
| Not Available |
| Full Name | Mikala A Legako Psyd Psych Svc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 83 Bailey Dr, Newnan, Georgia |
| Authorized Official Name and Position | Mikala Anne Legako (PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 6783147469 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mikala A Legako Psyd Psych Svc 83 Bailey Dr Newnan GA 30263-2913 Ph: (678) 314-7469 | Mikala A Legako Psyd Psych Svc 83 Bailey Dr Newnan GA 30263-2913 Ph: (678) 314-7469 |
| NPI Number | 1952571101 |
|---|---|
| Provider Enumeration Date | 03/04/2008 |
| Last Update Date | 08/02/2020 |
| Certification Date | 08/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952571101 | NPI | - | NPPES |
| 002428 | Other | GA | PSYCHOLOGY LICENSE |
| 000895617B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 002428 (Georgia) | Primary |
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