| NPI | 1659695286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATIYA JACKSON OSHODI Owner 678-542-7690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW003379) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |