| NPI | 1649443003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA D DYER Owner 706-548-8440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist Cognitive & Behavioral (Licence: GA 3109) |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2008-06-20 |