| NPI | 1114643905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA C CHERRY Owner Of Entity 770-231-3593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-10-13 |
| Last Update Date | 2022-12-02 |