| NPI | 1114466257 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANETTE GAINES Licensed Professional Counselor 404-725-5809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: VA 0701005533) |
| Enumeration Date | 2017-02-22 |
| Last Update Date | 2017-02-22 |