| NPI | 1780125948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORIEN MAGNUS Co Owner 678-926-9859 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC009289) |
| Enumeration Date | 2017-03-20 |
| Last Update Date | 2017-03-20 |