| NPI | 1083830400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE LICHTMAN Office Manager 912-489-1629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |