| NPI | 1477754067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BLACK Owner 770-378-5986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225XP0200X Occupational Therapist, Pediatrics (Licence: GA 003199) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2020-08-22 |