NPI | 1427323120 |
---|---|
Entity Type | Organization |
Authorized Contact | WINSTON DILL Owner 912-882-6448 |
Organization Subpart ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY003277) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN196911) |
Enumeration Date | 2012-03-13 |
Last Update Date | 2012-03-13 |