| NPI | 1184013195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTIN RICHARD RAY Therapist 678-288-5767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA APC004315) |
| Enumeration Date | 2015-01-14 |
| Last Update Date | 2015-01-14 |