| NPI | 1598148090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY BLANCO-BOOTH Therapist/Owner 706-296-1713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA MFT001411) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2015-07-01 |