| NPI | 1265825566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRELL WALKER Owner/Operater 770-676-0589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 007754) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2015-03-10 |
| Last Update Date | 2022-12-23 |