| NPI | 1366807489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORICE NEIR Licensed Professional Counselor 770-203-9060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA LPC008485) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2015-12-16 |