| NPI | 1689067878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSONDRA JACKSON Mental Health Clinician 678-492-9332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA APC004749) |
| Enumeration Date | 2015-03-11 |
| Last Update Date | 2015-03-11 |