| NPI | 1467080168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN AHAVA Licensed Clinical Psychologist 478-595-3400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-03-29 |
| Last Update Date | 2020-03-29 |