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General NPI Number Information
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NPI Number | 1528377033
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Entity Type | Individual
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Provider Name | GERALYN MCNAMARA M.A., LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/30/2010
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Last Update Date | 02/03/2015
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Provider Practice Location Address
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Address Line | 2591 US HIGHWAY 17 SUITE 304
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City | RICHMOND HILL
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State | GA
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Zip | 31324-3864
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Country | US
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Telephone | 206-437-1549
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Fax |
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Provider Business Mailing Address
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Address Line | 280 BLUE MOON XING APT 434
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City | POOLER
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State | GA
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Zip | 31322-9704
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Country | US
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Telephone | 206-437-1549
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 001361
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License Number State | GA
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