| NPI | 1003320888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA VELEZ Clinical Psychologist & Owner 678-626-7207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003469) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY003469) |
| 103TH0004X Psychologist, Health (Licence: GA PSY003469) | |
| 103TR0400X Psychologist, Rehabilitation (Licence: GA PSY003469) | |
| Enumeration Date | 2017-12-01 |
| Last Update Date | 2021-05-28 |