| NPI | 1902109200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES NORD Executive Director 770-457-2759 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA 749) |
| Enumeration Date | 2010-12-08 |
| Last Update Date | 2010-12-08 |