NPI | 1295164549 |
---|---|
Entity Type | Organization |
Authorized Contact | TIFFANY LYNN SULLIVAN Owner 678-814-4375 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007416) |
Enumeration Date | 2013-11-07 |
Last Update Date | 2023-11-04 |