| NPI | 1114251188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSUELO REDDICK Owner 770-552-4655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 044067) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 044067) |
| Enumeration Date | 2009-09-24 |
| Last Update Date | 2009-09-24 |