| NPI | 1609639608 |
|---|---|
| Former Legal Business Name | MARCIA BLANE |
| Entity Type | Organization |
| Authorized Contact | MARCIA BLANE Owner/Therapist 678-379-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X |
| Enumeration Date | 2024-02-01 |
| Last Update Date | 2024-02-01 |