| NPI | 1578712766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNYETTA GITTENS WILLIS Licensed Psychologist 404-636-1457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA PSY003209) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2008-09-12 |