| NPI | 1770639940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE ELEANOR WIENER Psychologist 706-235-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA py 002326) |
| Enumeration Date | 2007-01-28 |
| Last Update Date | 2020-08-22 |