| NPI | 1982352928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KOLBY TERRELONGE CEO 770-401-8114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst |
| Additional Taxonomies | 111NX0100X Chiropractor Occupational Health |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2022-03-17 |
| Last Update Date | 2022-03-17 |