| NPI | 1629210604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY KAY CHANDLER Adminisrator 229-228-6182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA PSY002317) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC005497) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |