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 |