| NPI | 1588107650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTI DENISE LOGAN Owner 770-540-8631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005561) |
| Enumeration Date | 2016-11-22 |
| Last Update Date | 2016-11-22 |