| NPI | 1902969363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN ALLISON LANUM Psychologist 478-474-4073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY002796) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2020-08-22 |