| NPI | 1366690729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHETT J PUDER Licensed Psychologist 706-353-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA 3078) |
| Enumeration Date | 2008-08-28 |
| Last Update Date | 2008-08-28 |