| NPI | 1972969418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEMAL DOUTE Member/Clinician 678-489-7384 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA 001277) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 01277) |
| 101YM0800X Counselor, Mental Health (Licence: GA 001277) | |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2016-01-14 |