| NPI | 1477797769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES KIRVEN WEEKLEY Owner 770-441-9244 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY-0001852) |
| Enumeration Date | 2009-04-30 |
| Last Update Date | 2009-04-30 |