| NPI | 1841705290 |
|---|---|
| Doing Business As | PSYCHOLOGIST OFFICE |
| Entity Type | Organization |
| Authorized Contact | ANGELINA MADRID Office Manager 912-447-5530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY002167) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC008244) |
| 101YP2500X Counselor, Professional (Licence: GA LPC008245) | |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT001080) | |
| Enumeration Date | 2017-12-07 |
| Last Update Date | 2018-06-16 |