| NPI | 1891217824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE C KECK Owner/Lpc 706-504-9538 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009005) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2017-07-12 |