| NPI | 1174780084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYMIE HELEN LUCKOW FOX Psychologist 770-457-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA psy002999) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-22 |