| NPI | 1457628653 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANNA GAYNOR Owner 678-667-3565 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA psy003462) |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2023-10-27 |