| NPI | 1740801455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE MARIE REYNOLDS Clinical Psychologist 770-883-3038 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical |
| Additional Taxonomies | 103TH0004X Psychologist Health |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |