| NPI | 1619125655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT J LEENAN Office Adm 404-474-7021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY001580) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2010-04-02 |