| NPI | 1174739155 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAMOND LOGSDON-CONRADSEN President 770-642-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 2347) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: GA 2347) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2008-07-23 |