| NPI | 1457764607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAM DRAKON Lpc 404-509-5883 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2014-06-05 |
| Last Update Date | 2014-06-05 |