| NPI | 1982918801 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK RICHARDSON Owner 770-507-0560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 054273) |
| Enumeration Date | 2010-08-03 |
| Last Update Date | 2010-08-03 |