| NPI | 1912684945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY SIOBHAN ANDERSON CEO 470-682-3536 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103K00000X Behavior Analyst | |
| 103TC0700X Psychologist, Clinical | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2023-12-06 |