| NPI | 1477959807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | D DIONNE BATES Owner 912-755-7069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005007) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2014-11-12 |