| NPI | 1225079114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID CARL GHOSTLEY Owner 334-699-1620 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: AL 1262) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2013-08-19 |