| NPI | 1194283507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON ROBERT COLE Owner 678-536-5226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 103T00000X Psychologist |
| 104100000X Social Worker | |
| Enumeration Date | 2019-03-05 |
| Last Update Date | 2019-03-05 |