| NPI | 1790901742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE R. EVANS Office Manager 912-355-5112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY000693) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY001478) |
| Enumeration Date | 2007-04-18 |
| Last Update Date | 2023-08-24 |