| NPI | 1407495666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA PROPHET Owner/Licensed Counselor 770-628-5368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-01-04 |
| Last Update Date | 2022-11-22 |