| NPI | 1487964193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW HARRELL Executive Director 770-899-8187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |