| NPI | 1376892703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JO D FADDIS Marriage & Family Therapist 404-325-0738 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 000295) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2012-08-30 |