| NPI | 1912398868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA AUSTIN NORTHROP Owner 678-332-7955 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| 101YM0800X Counselor Mental Health | |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2025-05-15 |