| NPI | 1164064366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ELAINE MOSS Owner 770-283-8386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2023-11-17 |