| NPI | 1174995088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY E. EDGE Therapist 478-290-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004884) |
| Enumeration Date | 2015-10-30 |
| Last Update Date | 2015-10-30 |