| NPI | 1952169237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA LYNN SUMNER BROWN Dr. 678-978-9391 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2024-03-11 |
| Last Update Date | 2024-03-11 |