| NPI | 1578070504 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELEINE SHAVER Owner 912-272-5744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW004705) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC009266) |
| Enumeration Date | 2017-12-28 |
| Last Update Date | 2017-12-28 |