| NPI | 1588018543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLT DAVIS Credentialing Specialists 912-484-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5480) |
| Enumeration Date | 2016-04-15 |
| Last Update Date | 2016-04-15 |