| NPI | 1285745331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA LINDAU Clinical Social Worker 912-882-3662 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: GA 042216) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW000885) |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW000182) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 042216) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2025-09-11 |