| NPI | 1487939096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE JONES Therapist 770-862-6088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC006520) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |