Doctor Name: | GINA MARIE LOVE |
NPI Number: | 1386684157 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | 6301011905 |
Business Practice Address: | 2101 Dutch Fork Rd Chapin, SC - 290367576 |
Business Phone Number: | 9107429243 |
Business Fax Number: | 8887461787 |
Mailing Address: | Po Box 538622, ATLANTA |
State: | GA |
Postal Code: | 303538622 |
Phone Number: | 9107429243 |
Fax Number: | 8887461787 |
NPI Enumeration Date: | 06/08/2006 |
NPI Last Update Date: | 10/06/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6301011905 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |