| NPI | 1871044990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMEERA ALI Billing Manager 678-793-1383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 5508) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: SC 6121) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |