| NPI | 1912730862 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAQUITA SHORTS Owner 470-214-9572 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2024-08-24 |
| Last Update Date | 2024-08-24 |