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DR. LANINA ELIZABETH MOMPREMIER PHD
Clinical >> Psychologist >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1780242164
Individual Registrant:DR. LANINA ELIZABETH MOMPREMIER PHD
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
5011 OAK TREE LN STONE MTN, GA 30087-3289 US
Tel: 240-339-3518 Fax: --
Tel: 240-339-3518 Fax: --
Contact information for business:
1227 ROCKBRIDGE RD. SW STE 208, BOX 364 STONE MOUTAIN, GA 30087 US
Tel: 240-339-3518 Fax: --
Tel: 240-339-3518 Fax: --
Registration Information:
NPI: 1780242164
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 103TC0700X | Behavioral Health & Social Service Providers Psychologist Clinical | VA | 08100004543 |
| N | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | MD | 05139 |
| Y | 103TC0700X | Behavioral Health & Social Service Providers Psychologist | DC | PSY1000830 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
