| NPI | 1558695577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SONYA BOSWELL Business Manager 770-813-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: GA 1464) |
| Enumeration Date | 2009-09-23 |
| Last Update Date | 2009-09-23 |