| NPI | 1518173731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JEFFREY TERRELL Owner 404-323-0734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC004388) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC004712) |
| 101Y00000X Counselor (Licence: GA LPC004747) | |
| 103T00000X Psychologist (Licence: GA PSY002025) | |
| 103T00000X Psychologist (Licence: GA PSY002456) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |