| NPI | 1154652071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM CHRISTOPHER MAYO Psychotherapist 706-714-9635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW004196) |
| Enumeration Date | 2010-01-15 |
| Last Update Date | 2010-01-15 |