| NPI | 1710392055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THANE BROOKS President 678-648-7644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1062816) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2015-03-11 |