| NPI | 1487196192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN SACKELLARES Lcsw 678-740-3022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004566) |
| Enumeration Date | 2016-11-11 |
| Last Update Date | 2016-11-30 |