| NPI | 1760685762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH E WALKER Director 706-529-6647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY002410) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC004957) |
| 101YP2500X Counselor, Professional (Licence: GA LPC005897) | |
| Enumeration Date | 2007-06-07 |
| Last Update Date | 2011-03-18 |