| NPI | 1720539562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONI R MORMANT Director 770-910-9162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 103TC0700X Psychologist Clinical | |
| 1041C0700X Social Worker Clinical | |
| 106H00000X Marriage & Family Therapist | |
| 106S00000X Behavior Technician | |
| 163WC1500X Registered Nurse Community Health | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 251S00000X Community/Behavioral Health (Licence: GA 1184963357) | |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2016-10-17 |
| Last Update Date | 2023-07-05 |