| NPI | 1538562590 |
|---|---|
| Former Name | CHRISTINA ANNE TALMADGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY004515) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 11104) |
| 101YP2500X Counselor Professional (Licence: NC A11104) | |
| Enumeration Date | 2014-10-06 |
| Last Update Date | 2021-09-16 |