| NPI | 1003259334 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT DAVID RUSSELL Counselor 404-452-3789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC004424,LPC004531) |
| Enumeration Date | 2013-04-17 |
| Last Update Date | 2013-04-17 |