| NPI | 1366574618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MERRIDY K VESCOVO Vice President 770-498-6300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA 2378LPC) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA 867LMFT) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2020-08-22 |