| NPI | 1871950758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J MOORE CEO 770-642-6100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC1900X Psychologist Counseling | |
| 103TC2200X Psychologist Clinical Child & Adolescent | |
| 103TH0100X Psychologist Health Service | |
| 103TP0016X Psychologist Prescribing (Medical) | |
| 103TS0200X Psychologist School | |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2016-01-22 |