| NPI | 1841488350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN J RICHARDS Owner 678-310-3442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TF0200X Psychologist, Forensic (Licence: GA PSY002508) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: GA PSY002508) |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2011-06-01 |