Provider Demographics
NPI:1518080092
Name:HALLMAN, LORRAINE K (PHD)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:K
Last Name:HALLMAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:LORRIE
Other - Middle Name:
Other - Last Name:HALLMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:1904 MONROE DR NE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4858
Mailing Address - Country:US
Mailing Address - Phone:404-873-5503
Mailing Address - Fax:404-873-4028
Practice Address - Street 1:1904 MONROE DR NE
Practice Address - Street 2:SUITE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4858
Practice Address - Country:US
Practice Address - Phone:404-873-5503
Practice Address - Fax:404-873-4028
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA464103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA68BBDGMMedicare ID - Type Unspecified