| NPI | 1073081220 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURA CAILIN ALLEN Office Manager 706-756-1970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 103TC1900X Psychologist, Counseling | |
| Enumeration Date | 2018-11-06 |
| Last Update Date | 2018-11-06 |