| NPI | 1528416278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN HART Licensed Mental Health Counselor 229-516-0476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |