| NPI | 1659924751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MITCHELL Chief Managing Officer 404-516-1996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2019-07-18 |
| Last Update Date | 2019-07-18 |