| NPI | 1093802233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK MANFRED ROLAND President 770-420-9448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 1872) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 897) |
| Enumeration Date | 2006-10-09 |
| Last Update Date | 2020-08-22 |