Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY004174 | GA |
NPI | 1023668472 |
---|---|
Provider Name | Dr. Ashley Badger |
First Address | Savannah, GA 31401-5922 |
Second Address | Savannah, GA 31406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2019 |
Last Update Date | 18/09/2019 |