| NPI | 1013538164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVONDA HUDSON Mental Health Therapist 678-506-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-06-21 |