| NPI | 1285824425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI A. WILSON Clinical Psychologist 770-677-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA PSY002210) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2007-07-25 |