| NPI | 1720496656 |
|---|---|
| Doing Business As | PSYCHOLOGY & PSYCHOTHERAPY |
| Entity Type | Organization |
| Authorized Contact | KATHY CLARK Administrator / Therapist 678-995-5398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2014-07-23 |
| Last Update Date | 2014-07-23 |