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DR. LANINA ELIZABETH MOMPREMIER PHD

Clinical >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1780242164

Individual Registrant:
DR. LANINA ELIZABETH MOMPREMIER PHD
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: --

Contact information for business:
1227 ROCKBRIDGE RD. SW STE 208, BOX 364 STONE MOUTAIN, GA 30087 US
Tel: 240-339-3518  Fax: --

Registration Information:
NPI: 1780242164
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
Clinical
VA08100004543
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
MD05139
Y103TC0700XBehavioral Health & Social Service Providers
Psychologist
DCPSY1000830

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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