| NPI | 1962612614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNETTE VIRGINIA FARR Owner 770-507-4124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TA0700X Psychologist, Adult Development & Aging (Licence: GA MFT000296) |
| Additional Taxonomies | 103TB0200X Psychologist, Cognitive & Behavioral (Licence: GA MFT000296) |
| 103TC1900X Psychologist, Counseling (Licence: GA MFT000296) | |
| 106H00000X Marriage & Family Therapist (Licence: GA MFT000296) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2025-09-11 |