| NPI | 1558176545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARYN PONS Owner 678-856-5042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2025-02-08 |
| Last Update Date | 2025-02-10 |