| NPI | 1568981686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMY CHAD MERRITT Owner 229-220-7812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007658) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2021-06-24 |