| NPI | 1780694844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI L NELSON Owner Lpc Lmhc 229-227-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6282) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 3131) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |