NPI | 1942610845 |
---|---|
Entity Type | Organization |
Authorized Contact | WAYDE J WASHBURN Owner/Counselor 706-594-4735 |
Organization Subpart ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 012692) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC003428) |
101YM0800X Counselor, Mental Health (Licence: GA LPC002077) | |
Enumeration Date | 2014-04-30 |
Last Update Date | 2014-04-30 |