| NPI | 1134691496 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SAMUEL MARION Managing Director 229-456-2022  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101YP2500X Counselor, Professional | 
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2018-12-27 | 
| Last Update Date | 2022-08-04 |