| NPI | 1194235028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON N MYERS Medical Director 706-842-5331 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: GA OT006115) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT011580) |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-01-04 |