Vanessa Bautista
NPI #1588485825 in Fort Moore, Georgia
Provider Information
- NPI Number
- 1588485825
- Entity Type
- Individual
- Name
- Vanessa Bautista
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Psychologist - School
- Enumeration Date
- Oct 19, 2024
- Last Updated
- Oct 19, 2024
Practice Location
- Address
- 5253 10TH ARMORED LOOP
- City
- Fort Moore
- State
- Georgia
- ZIP Code
- 31905-7088
- Phone
- (831) 245-8662
Specialties & Taxonomy Codes
| Specialty |
|---|
| Psychologist - School — School |
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