| NPI | 1114479946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH C VANDYCK Owner 404-337-1331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW005458) |
| Enumeration Date | 2016-10-27 |
| Last Update Date | 2016-10-27 |