| NPI | 1336800283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELVIDA LONG Psychologist 478-216-8555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2022-01-03 |