| NPI | 1497977003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OGENE LEWIS DAVIS President, Registered Agent 404-292-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA LPC003621) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |