| NPI | 1376804062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA MYSLEWICZ-WEESE Licensed Clinical Social Worker 912-506-6983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA CSW004564) |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |