| NPI | 1689167439 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKHOL B. JACKSON Owner 770-377-4834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007280) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2018-06-06 |