| NPI | 1861650996 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA COPPOLA Principal 678-488-1476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW003058) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |