| NPI | 1518290857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY AYCOCK President 770-461-9944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: GA PSY001928) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC002250) |
| 1041C0700X Social Worker, Clinical (Licence: GA CSW000340) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |