| NPI | 1386761237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN RUDNICKI Psychologist 770-924-1818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 2723) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2020-08-22 |