| NPI | 1194202911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SUE BRADSHAW-LIVINGSTON Licensed Psychologist 404-249-0520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA 003691) |
| Enumeration Date | 2018-07-24 |
| Last Update Date | 2018-07-24 |