| NPI | 1518628023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX W PETERSON Owner 404-736-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2022-01-06 |