| NPI | 1790146900 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSIDY NICOLE THIGPEN Licensed Professional Counselor 706-833-0780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008833) |
| Additional Taxonomies | 251S00000X |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2016-03-15 |
| Last Update Date | 2024-02-27 |