| NPI | 1114085743 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CLYDE MARTIN Owner/Partner 770-732-0982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY001373) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY001157) |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW000729) | |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-08-10 |