| NPI | 1881190700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE LOGAN Licensed Professional Counselor 404-382-8788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |