| NPI | 1083989479 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | F. RICHARD BLUE Psychologist 404-705-9770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 515) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |