NPI | 1679962393 |
---|---|
Entity Type | Organization |
Authorized Contact | JD JACKSON Executive Director 678-856-5031 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007193) |
Enumeration Date | 2015-01-19 |
Last Update Date | 2015-01-19 |