| NPI | 1013459676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA ABRAHAM Lpc 706-836-3193 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009282) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC009282) |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC009282) | |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |