| NPI | 1679791552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY DRAISIN WOLMAN Owner 404-255-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: GA 1019) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: GA 1019) |
| 103TC2200X Psychologist Clinical Child & Adolescent (Licence: GA 1019) | |
| 103TF0000X Psychologist Family (Licence: GA 1019) | |
| 103TM1800X Psychologist Mental Retardation & Developmental Disabilities (Licence: GA 1019) | |
| 103TS0200X Psychologist School (Licence: GA 1019) | |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |