| NPI | 1558580571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNA W. GRISHAM Licensed Psychologist 770-645-9801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: GA 1449) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2020-08-22 |