| NPI | 1184991705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEODORE M GOETZ Psychologist 706-548-9441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA 698) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-11-28 |