| NPI | 1881864122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN THOMPSON Director 678-213-2194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA lpc003931) |
| Enumeration Date | 2008-03-03 |
| Last Update Date | 2008-03-03 |