| NPI | 1891655361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA VONCEIA ANDERSON Owner 470-642-0723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-11-17 |
| Last Update Date | 2025-12-04 |