| NPI | 1063852051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAELLE MYRTHIL Psychotherapist 678-697-7018 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004380) |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2013-07-05 |