| NPI | 1437408127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA OREM Practice Manager 770-233-2809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC001607) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001185) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 0406) | |
| 101YP2500X Counselor, Professional (Licence: GA APC002290) | |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2012-09-10 |