| NPI | 1821296567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE CANNON Director 404-243-1992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA 101YM0800X) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |