| NPI | 1235693342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY TAGTACHIAN Executive Director 770-548-2589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist Counseling |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-06-11 |