| NPI | 1720396773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEIDRE COBB TIFT President 912-977-4643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MSW002656) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 080640) |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-30 |