Your Info

Name of Practitioner or Practice
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Name*
E-mail*
Website

Essential Info

Practitioners Name*
practitioners/organization name
Additional practitioners
optional add if there is a second name/affiliated organizations
Practitioners type
Practitioners type or category, services provided etc..
Treatments
Provided treatments.
Prescribe Psychiatric Drugs
Do you prescribe any psychiatric drugs?
Help take patients off of psychiatric drugs
Do you help take patients off of psychiatric drugs if they wish to do so?
Comments about taking patients off of psychiatric drugs
Any comments about taking patients off of psychiatric drugs, such as under what conditions, procedure etc.
Other Notes
Location*
Address Line 1
City
State / Province / Region
Postal / Zip Code
Country
Latitude
Longitude
Categories
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Contact Info

Phone Number
Mobile Number
Fax Number
E-mail
Website

Social Accounts

Twitter
Facebook URL
Google+ URL

Additional Info

Notes
additional note or details.
Photos
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