| NPI | 1700158912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE CHAMBERS DIERKS Member 404-218-1739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001084) |
| Enumeration Date | 2012-02-02 |
| Last Update Date | 2014-04-04 |