| NPI | 1588019533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA POWELL Billing Coordinator 706-421-9262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA PS-P000238) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2016-04-27 |