| NPI | 1184079030 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LIBBY TANNENBAUM Clinical Psychologist 404-281-6477 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA PSY2710) | 
| Enumeration Date | 2016-04-28 | 
| Last Update Date | 2016-04-28 |