| NPI | 1518237361 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLYN ST.LIFER KOORIS Lcsw 678-925-3516 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW003845) | |
| 1041C0700X Social Worker, Clinical (Licence: MA 1021709) | |
| 106H00000X Marriage & Family Therapist | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |