| NPI | 1962780171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MICHELLE KUMPEL President 229-333-9632 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 54448) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2012-02-29 |