| NPI | 1649719550 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONTESSA STRADER Director 678-524-1220 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor, Professional | |
| 103T00000X Psychologist | |
| 103TB0200X Psychologist, Cognitive & Behavioral | |
| 103TC2200X Psychologist, Clinical Child & Adolescent | |
| Enumeration Date | 2017-02-13 |
| Last Update Date | 2017-02-13 |