NPI | 1174947071 |
---|---|
Entity Type | Organization |
Authorized Contact | JESSE R ELLINGTON Owner 678-933-1883 |
Organization Subpart ? | No |
Primary Taxonomy | 103K00000X Behavior Analyst |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health | |
101YP1600X Counselor, Pastoral | |
101YP2500X Counselor, Professional | |
102X00000X Poetry Therapist | |
103G00000X Clinical Neuropsychologist | |
103T00000X Psychologist | |
103TB0200X Psychologist, Cognitive & Behavioral | |
103TC2200X Psychologist, Clinical Child & Adolescent | |
103TE1100X Psychologist, Exercise & Sports | |
103TP0016X Psychologist, Prescribing (Medical) | |
103TP2701X Psychologist, Group Psychotherapy | |
1041S0200X Social Worker, School | |
106H00000X Marriage & Family Therapist | |
Enumeration Date | 2014-02-12 |
Last Update Date | 2014-02-12 |