| NPI | 1679660666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE MCNULTY Sole Proprietor 770-289-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC000664) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2022-07-21 |