| NPI | 1386466118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YEBU YAYE JALLOH CHARLES Owner 770-527-6341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-10-31 |
| Last Update Date | 2024-10-31 |