| NPI | 1891039855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIN HARRELL JANSEN Owner 404-937-0725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA CSW004280) |
| Additional Taxonomies | 251S00000X (Licence: GA CSW004280) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2012-11-15 |