| NPI | 1174714570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA METZ Office Manager 770-458-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: GA GA017757) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: GA ga017757) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2007-08-09 |