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1235627399
CARISSA BALDERAS
DECATUR, GA
NPI
1235627399
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
103TC0700X Psychologist, Clinical
(Licence: GA PSY004175)
Enumeration Date
2018-04-24
Last Update Date
2018-04-24
Business Address
CARISSA BALDERAS PhD
1670 CLAIRMONT RD
DECATUR, GA 30033-4004
Phone number: 404-321-6111
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Mailing Address
CARISSA BALDERAS PhD
5003 FIVE OAKS WAY
TUCKER, GA 30084-8166
Phone number: 562-652-3744
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