Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | 0810005577 | VA |
N | 103TC0700X | Clinical Psychologist | 0810005577 | VA |
N | 103G00000X | Clinical Psychologist | PSY004143 | GA |
N | 103TC0700X | Clinical Psychologist | PSY004143 | GA |
N | 103G00000X | Clinical Psychologist | 0810005577 | VA |
N | 103TC0700X | Clinical Psychologist | 0810005577 | VA |
N | 103TR0400X | Rehabilitation Psychologist | 0810005577 | VA |
Y | 2084N0600X | Clinical Neurophysiologist | PSY004143 | GA |
NPI | 1497283584 |
---|---|
Provider Name | Dr. Sara Ann Schleicher-Dilks |
First Address | Atlanta, GA 30374-2616 |
Second Address | Gainesville, GA 30501-3875 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2017 |
Last Update Date | 30/09/2021 |