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General NPI Number Information
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NPI Number | 1902650096
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Entity Type | Individual
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Provider Name | LAURA MADINGER MED
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Gender | Female
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Dates
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Enumeration Date | 04/15/2024
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 700 CHURCHILL CT STE 140
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City | WOODSTOCK
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State | GA
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Zip | 30188-6846
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Country | US
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Telephone | 404-851-7711
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Fax |
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Provider Business Mailing Address
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Address Line | 763 OLD PAPER MILL DR SE
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City | MARIETTA
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State | GA
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Zip | 30067-5162
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Country | US
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Telephone | 404-851-7711
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 008446
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License Number State | GA
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