| NPI | 1053853515 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELITA DELORES BUSH Lpc 470-629-3380 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 009211) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN076947) |
| Enumeration Date | 2016-11-14 |
| Last Update Date | 2016-11-14 |