Gangarosa-Emerson, Maria E

Gangarosa-Emerson, Maria E is an sole proprietor health care provider with primary practice located at 302 Baston Rd , Martinez GA 30907-2906. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Neuropsychologist. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Gangarosa-Emerson, Maria E can be contacted via phone (706) 447-8700.

Contact Information

Primary practice address
302 Baston Rd Martinez GA 30907-2906
Phone: (706) 447-8700
Fax: (706) 447-8701
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 0002381 Georgia
Behavioral Health & Social Service Providers / Clinical Neuropsychologist 103G00000X 2381 Georgia

Profile Details

NPI number 1144437989
LBN Legal business name Gangarosa-Emerson, Maria E
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 17th, 2007
Last updated Feb 19th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144437989 NPPES
Georgia MEDICAID 000852277B
Georgia Other 020657518001
Georgia Other 52669312-001
Georgia Other 020657518

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