| NPI | 1831426162 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEWIS ROBERT LIEBERMAN Secretary/Treasurer 706-561-4625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 205) |
| Enumeration Date | 2009-11-06 |
| Last Update Date | 2009-11-06 |