| NPI | 1588876221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD SHOOK Licensed Psychologist 770-514-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY1908) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2020-08-22 |