| NPI | 1205349644 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DAVID PHILLIPS Counselor/Therapist 678-779-8739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3758) |
| Enumeration Date | 2017-11-07 |
| Last Update Date | 2018-03-17 |