Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | PSY001956 | GA |
NPI | 1093809048 |
---|---|
Provider Name | Mrs. Ruth A Nelson-Abbott |
First Address | Augusta, GA 30909-6549 |
Second Address | Augusta, GA 30909-6549 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 04/06/2009 |