Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY004327 | GA |
NPI | 1114546017 |
---|---|
Provider Name | Joya N Hampton-Anderson |
First Address | Atlanta, GA 30307-1242 |
Second Address | Atlanta, GA 30329-2206 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2020 |
Last Update Date | 10/04/2020 |