| NPI | 1306993795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN COLLINS MCCORMACK President 706-733-7029 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY000601) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2007-12-18 |