| NPI | 1184957284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE S. ROYSTER Therapist 770-330-3418 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC050099) |
| Enumeration Date | 2009-09-08 |
| Last Update Date | 2009-09-08 |