NPI | 1427571322 |
---|---|
Entity Type | Organization |
Authorized Contact | KATRINA L LOKKEN Owner 678-820-8386 |
Organization Subpart ? | No |
Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
Additional Taxonomies | 101YP2500X Counselor, Professional |
103TC0700X Psychologist, Clinical (Licence: GA PSY003288) | |
103TC0700X Psychologist, Clinical | |
Enumeration Date | 2017-07-23 |
Last Update Date | 2022-07-21 |