| NPI | 1316216880 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA FAULKNER Owner/Director 678-712-6520 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA PSY002144) |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2017-05-03 |