| NPI | 1306165634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY GILMORE RANDELL CEO/Licensed Psychologist 678-462-5478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA PY003365) |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2010-05-26 |