| NPI | 1114196912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENELLA LAZENBY-AUSBORN Vice President/Chief Financial Offi 770-938-4616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2008-02-26 |
| Last Update Date | 2024-08-01 |