| NPI | 1710644372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA RENZI Clinic Coordinator 706-542-2252 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist |
| 1041C0700X Social Worker, Clinical | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 3336C0002X Pharmacy, Clinic Pharmacy | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2021-11-18 |