| NPI | 1609138890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHARLES FRONTMAN Psychologist 678-624-0930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 1835) |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |