| NPI | 1689039661 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH Z JACKSON Psychotherapist 706-425-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA csw005424) |
| Enumeration Date | 2015-12-17 |
| Last Update Date | 2015-12-17 |