| NPI | 1174601348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUANN B WOODS Office Manager 678-630-4963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2022-05-17 |