| NPI | 1487149340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKSON K EDWARDS Director 404-334-5859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW006235) |
| Enumeration Date | 2018-06-24 |
| Last Update Date | 2018-06-24 |