| NPI | 1215092366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EILEEN FIELDS Office Administrator 770-952-1032 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 344) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA 270) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |