| NPI | 1871170449 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KELLY ELIZABETH HUGHES Clinical Direction 770-695-7501 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical | 
| Enumeration Date | 2021-03-28 | 
| Last Update Date | 2021-03-28 |