| NPI | 1881043420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA TODD Executive Director 678-626-0557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: GA 1-12-10491) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: GA 1-15-19619) |
| 106H00000X Marriage & Family Therapist (Licence: GA AMFT000418) | |
| 174400000X Specialist (Licence: GA MUT000049) | |
| 246Z00000X Specialist/Technologist, Other (Licence: GA RBT-16-19812) | |
| Enumeration Date | 2016-06-05 |
| Last Update Date | 2021-02-10 |