| NPI | 1912377433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA L WANZO Owner 678-566-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 35165) |
| Enumeration Date | 2015-09-26 |
| Last Update Date | 2015-09-26 |