| NPI | 1922286731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAYNA M DIAZ Licensed Psychologist 770-452-5353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: GA PSY002970) |
| Additional Taxonomies | 103TC2200X Psychologist, Clinical Child & Adolescent (Licence: GA PSY002970) |
| 103TF0000X Psychologist, Family (Licence: GA PSY002970) | |
| 103TP2701X Psychologist, Group Psychotherapy (Licence: GA PSY002970) | |
| Enumeration Date | 2008-02-04 |
| Last Update Date | 2008-02-04 |