| NPI | 1407465354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EXTRIARA CHARLESH GATES Psychotherapist/ Owner 404-490-0031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2020-07-27 |