| NPI | 1760947204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONJALA GAINEY-GRANT Nurse Practitioner 770-925-5065 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2019-02-08 |
| Last Update Date | 2019-02-08 |