| NPI | 1912252313 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANIKE KIARA OLUGBALA Owner 770-502-5593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW004694) |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2017-03-02 |