Provider Demographics
NPI:1487103834
Name:KAMERMAN, MERCEDES (PSYD)
Entity type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:KAMERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 ELLIOTT RD STE 220
Mailing Address - Street 2:
Mailing Address - City:DAWSONVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30534-8904
Mailing Address - Country:US
Mailing Address - Phone:706-203-1503
Mailing Address - Fax:
Practice Address - Street 1:75 ELLIOTT RD
Practice Address - Street 2:
Practice Address - City:DAWSONVILLE
Practice Address - State:GA
Practice Address - Zip Code:30534-8901
Practice Address - Country:US
Practice Address - Phone:706-203-1503
Practice Address - Fax:706-203-1504
Is Sole Proprietor?:No
Enumeration Date:2016-09-27
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPSY004052103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist