NPI | 1639425150 |
---|---|
Entity Type | Organization |
Authorized Contact | LYLE COALWELL Counselor 770-298-5094 |
Organization Subpart ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC002580) |
Additional Taxonomies | 174400000X Specialist |
Enumeration Date | 2012-08-02 |
Last Update Date | 2012-08-02 |