| NPI | 1487888566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH MARIE WILSON Professional Counselor 706-825-8472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA LPC004458) |
| Additional Taxonomies | 251S00000X (Licence: TX 18226) |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |