| NPI | 1164895470 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONE D COAKLEY Owner 770-355-6073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004856) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |