| NPI | 1649991589 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROLAKE TOMOIRI Owner/Operator 404-936-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 103TC1900X Psychologist, Counseling |
| 103TM1800X Psychologist, Intellectual & Developmental Disabilities | |
| Enumeration Date | 2022-09-08 |
| Last Update Date | 2023-10-09 |