NPI | 1740648039 |
---|---|
Entity Type | Organization |
Authorized Contact | TANYA WHITE Owner/Provider 770-415-3442 |
Organization Subpart ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC 005475) |
Enumeration Date | 2016-02-02 |
Last Update Date | 2024-06-25 |