Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY002973 | GA |
Y | 103TC0700X | Clinical Psychologist | PSY002973 | GA |
N | 103TC1900X | Counseling Psychologist | PSY002973 | GA |
NPI | 1083771067 |
---|---|
Provider Name | Dr. Laura L Rencher |
First Address | Milton, GA 30004-2605 |
Second Address | Milton, GA 30004-2605 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2007 |
Last Update Date | 17/03/2018 |