| NPI | 1063704542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA LUE Business Owner 770-939-1288 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2020-10-22 |