| NPI | 1639343221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEA RABON MONTGOMERY CEO 678-205-0877 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 002433) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |