| NPI | 1376728394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK HOLLAND GRISHAM President 770-427-2911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA 000669 GA) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA 001135 GA) |
| 1041C0700X Social Worker, Clinical (Licence: GA GA CSW003681) | |
| Enumeration Date | 2008-01-09 |
| Last Update Date | 2008-01-09 |