| NPI | 1003266784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialists 912-484-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SC 6284) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |