| NPI | 1881404341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANEL COX Practice Manager 470-377-3977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-08 |