| NPI | 1255743670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEVAN N ISOM Office Manger, Biller, Credentialin 706-888-5599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 103TB0200X Psychologist Cognitive & Behavioral | |
| 103TC0700X Psychologist Clinical | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 1041S0200X Social Worker School | |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2024-08-28 |