| NPI | 1265895569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN POULOS Owner/Pediatric Psychologist 770-656-1365 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003708) |
| Enumeration Date | 2016-04-04 |
| Last Update Date | 2016-04-04 |