| NPI | 1457690760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAE SANSOM COLEY Licensed Clinical Social Worker 678-884-4011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004106) |
| Enumeration Date | 2013-02-06 |
| Last Update Date | 2014-01-22 |