| NPI | 1689072068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA FOUNTAIN Owner 678-871-9355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006900) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2016-06-17 |