| NPI | 1629236971 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WYTONA JOHNSON Director 770-438-6928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP2031) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2009-09-22 |