| Doctor Name: | DR. ANNA M EDWARDS-GAURA |
| NPI Number: | 1265657845 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PH.D. |
| License Number: | PSY002990 |
| Business Practice Address: | 182 Ben Burton Cir Suite 100 Bogart, GA - 306226847 |
| Business Phone Number: | 7069953160 |
| Business Fax Number: | |
| Mailing Address: | 182 Ben Burton Cir, Suite 100 BOGART |
| State: | GA |
| Postal Code: | 306226847 |
| Phone Number: | 7069953160 |
| Fax Number: | 7062434611 |
| NPI Enumeration Date: | 04/17/2007 |
| NPI Last Update Date: | 12/07/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TB0200X |
| License Number: | PSY002990 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | GA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Cognitive & Behavioral |
| Taxonomy Definition: | |