| 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 |