| NPI | 1316668247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUE DAVIS Credentialist 404-963-2647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2022-09-08 |