| NPI | 1609650258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialista 912-373-4385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical | |
| 251S00000X | |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2024-04-25 |