| NPI | 1700516424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWIN WALLACE ROBERTS CEO 404-403-1545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral |
| 103TC1900X Psychologist, Counseling | |
| 103TF0000X Psychologist, Family | |
| 103TP2701X Psychologist, Group Psychotherapy | |
| 104100000X Social Worker | |
| 106E00000X Assistant Behavior Analyst | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2022-06-15 |
| Last Update Date | 2022-06-15 |