| NPI | 1255162434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH WISE Owner 404-502-6868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-12 |