| NPI | 1871615393 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA LYNN PUGH President 770-844-8624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TM1800X Psychologist, Intellectual & Developmental Disabilities |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA APC001104) |
| 111NR0400X (Licence: GA CHIR007818) | |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2008-09-29 |