| NPI | 1053947408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA FOLDEN Owner 770-605-6491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2020-03-18 |
| Last Update Date | 2023-03-30 |