| NPI | 1538671581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA KOALENZ Owner 678-896-8959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2024-04-29 |