| NPI | 1811574890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHATIAH DOW-REYES Counselor 678-884-3257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| Enumeration Date | 2021-03-25 |
| Last Update Date | 2021-03-25 |