| NPI | 1326669474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAVONDA HUDSON Licensed Professional Counselor 678-506-7499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |