| NPI | 1609916147 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY ELIZABETH BLACK CEO 064-903-5357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC 003219) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2023-03-13 |