| NPI | 1124310727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JILL C ANDERSON Owner 404-542-5287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003030) |
| Enumeration Date | 2011-05-14 |
| Last Update Date | 2011-05-14 |