| NPI | 1457898371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA E WEISS Owner 404-474-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 059789) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: GA 059789) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2017-01-30 |