NPI | 1720358302 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANK MACK Executive Director 478-745-2811 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC005010) |
Enumeration Date | 2012-01-12 |
Last Update Date | 2012-01-12 |