| NPI | 1437719382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BOCCUTI Owner And Founder 770-919-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YP2500X Counselor Professional | |
| 103T00000X Psychologist | |
| 103TC0700X Psychologist Clinical | |
| 103TC1900X Psychologist Counseling | |
| 104100000X Social Worker | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-23 |