| NPI | 1427601905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI BURGESS Owner 678-772-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |