| NPI | 1124251590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA SAPORITA THERIOT Owner, Clinical Psychologist 770-310-1792 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY002887) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2009-09-01 |