| NPI | 1942792346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADISON T WEST Owner 678-740-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001316) |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2018-05-31 |