| NPI | 1457541823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY Q ROPER Owner/Partner/Lpc 706-576-6575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 305S00000X Point of Service (Licence: GA 238939) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2021-07-09 |