| NPI | 1083086581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWNETTE NICHOLE MILLER Clinical Social Worker Therapist 678-833-1664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CSW004801) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2015-10-22 |