| NPI | 1801536438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLO KEENAN License Professional Counselor 770-712-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-03-31 |