| NPI | 1093041584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNAMARIE SPILLANE PAULSEN Owner 770-922-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TP0016X Psychologist, Prescribing (Medical) (Licence: GA 029066) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |