| NPI | 1770282154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI MARIE EVANS-GADSON Counselor 912-433-4591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2023-02-24 |
| Last Update Date | 2024-04-15 |