| NPI | 1598124695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY NICHOLS TAGTACHIAN Administrator 770-548-2589 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2022-07-21 |