| NPI | 1134638992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNAI LOPEZ TAVIRA CRUZ Child & Family Therapist 770-361-4607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: GA MFT001573) |
| Enumeration Date | 2017-09-25 |
| Last Update Date | 2019-04-03 |