| NPI | 1285056135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY L DAVIS Credentialing Specialists 912-484-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5358) |
| Enumeration Date | 2014-01-13 |
| Last Update Date | 2014-01-13 |