| NPI | 1134748676 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL DAVID SHORTER Owner/Therapist 770-853-8561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |