| NPI | 1790197804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON KEITH DUNLAP Owner/Director 706-884-5050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY003497) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2015-06-29 |