| NPI | 1073848552 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA KAY BENTLEY Licensed Professional Counselor 706-836-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA LPC005710) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA LPC005710) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA CSW003760) | |
| 1041C0700X Social Worker Clinical (Licence: GA CSW003760) | |
| Enumeration Date | 2009-10-16 |
| Last Update Date | 2009-10-16 |