| NPI | 1134259559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GREGORY KAPPHAHN Director 770-394-5447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA LPC001424) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA LPC001539) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2020-08-22 |