| 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 |