| NPI | 1093602427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA K WORTHINGTON Mgr 678-456-2278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2025-06-19 |
| Last Update Date | 2025-07-18 |