| NPI | 1861090102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI HOFSTADTER-DUKE Manager 912-658-5883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC2200X Psychologist, Clinical Child & Adolescent |
| Enumeration Date | 2020-10-09 |
| Last Update Date | 2020-10-09 |