| NPI | 1578956314 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVENIA W. MARABLE Counselor/Therapist 770-845-2328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA 07102704) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2015-03-17 |