| NPI | 1962864462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATRINA ANNETTE O'NEAL Owner 229-630-9948 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001028) |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-24 |