| NPI | 1679870679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY ADELE MCKINNEY Owner/Provider 404-281-1698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC003685) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC003685) |
| Enumeration Date | 2011-02-28 |
| Last Update Date | 2011-02-28 |