| NPI | 1154567824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHEAUX HALL Office Manager 678-513-0313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 894) |
| Enumeration Date | 2008-12-30 |
| Last Update Date | 2023-02-20 |