| NPI | 1093026601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN AZAR-DICKENS Licensed Psychologist 706-234-0659 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 002459) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |