| NPI | 1144512591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINNISE PETTWAY Owner/President 770-642-4236 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006121) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |