| NPI | 1487908026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RIC CHAMBERS Licensed Professional Counseling 770-304-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2022-07-21 |