| NPI | 1942085832 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRTLE HOWARD DAVENPORT Nurse Practitioner/Owner 678-203-4595 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Enumeration Date | 2023-08-29 |
| Last Update Date | 2023-08-29 |