| NPI | 1053650689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY L DIAL Owner 678-596-0773 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT000748) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2013-02-01 |