Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | PSY003143 | GA |
NPI | 1093966715 |
---|---|
Provider Name | Julie R Oliver |
First Address | Atlanta, GA 30305-1717 |
Second Address | Atlanta, GA 30339-3915 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2008 |
Last Update Date | 10/01/2022 |