| NPI | 1215103767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHANIEL ANDREW WILSON Psychologist 404-550-9981 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA psy002857) |
| Enumeration Date | 2008-05-05 |
| Last Update Date | 2013-03-27 |