Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY003748 | GA |
NPI | 1023497609 |
---|---|
Provider Name | Dr. Karen Bearss |
First Address | Atlanta, GA 30329-4010 |
Second Address | Atlanta, GA 30329-4010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 28/05/2015 |