| NPI | 1619458825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BENTON Owner/ Therapist 706-549-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007064) |
| Enumeration Date | 2018-08-25 |
| Last Update Date | 2018-08-25 |