| NPI | 1881782431 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOEL P BAGBY Clinical Director 770-445-8079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 001431) |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2020-08-22 |