| NPI | 1851705768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA LIVERMAN Lpc/Owner 912-507-2483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC004419) |
| Enumeration Date | 2014-06-18 |
| Last Update Date | 2014-06-18 |