| NPI | 1083982714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WAYNE PHILLIPS President 770-850-4848 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY001038) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |