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1184025587
HEAVENLY THERAPEUTIC SERVICES LLC
FAYETTEVILLE, GA
NPI
1184025587
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Entity Type
Organization
Authorized Contact
FREDRIC DARNELL BLOCKER
Lpc
770-946-2312
Organization Subpart ?
No
Primary Taxonomy
101YP2500X Counselor Professional
Enumeration Date
2014-09-04
Last Update Date
2014-09-04
Business Address
HEAVENLY THERAPEUTIC SERVICES LLC
110 HABERSHAM DR STE 116
FAYETTEVILLE, GA 30214-1381
Phone number: 770-946-2312
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Mailing Address
HEAVENLY THERAPEUTIC SERVICES LLC
110 HABERSHAM DR STE 116
FAYETTEVILLE, GA 30214-1381
Phone number:
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