| NPI | 1144476847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOTTIE GRACE OLSON-DAVIDSON Owner 706-910-4588 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: VA 0701005309) |
| Enumeration Date | 2008-08-13 |
| Last Update Date | 2013-04-27 |