| NPI | 1114417722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN EUDETTE HAGGARD Owner 678-986-7458 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA csw004585) |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2022-03-24 |