| NPI | 1477619195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERN TAYLOR Office Manager 770-461-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 103T00000X Psychologist |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2020-08-22 |