| NPI | 1508077991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA BLACK Owner 770-378-5986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 2251P0200X Physical Therapist, Pediatrics | |
| Enumeration Date | 2007-05-25 |
| Last Update Date | 2025-10-13 |