| NPI | 1265957823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI HOFSTADTER-DUKE Owner 912-436-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY003639) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-04 |