| NPI | 1457627044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH E. MASON CEO 706-548-8697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY002674) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA PSY002674) |
| 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA PSY002674) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |