| NPI | 1023431210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODERICK BROWN Owner 678-335-9010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 005536) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 005397) |
| 101YP2500X Counselor, Professional (Licence: GA 006044) | |
| 101YP2500X Counselor, Professional (Licence: GA 006188) | |
| 101YP2500X Counselor, Professional (Licence: GA 006400) | |
| 101YP2500X Counselor, Professional (Licence: GA 006760) | |
| 101YP2500X Counselor, Professional (Licence: GA 006205) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: GA 046882) | |
| 103TP0016X Psychologist, Prescribing (Medical) (Licence: GA 10576464) | |
| Enumeration Date | 2014-01-24 |
| Last Update Date | 2014-01-24 |