| NPI | 1992178230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNALEIGHA MORIARTY Owner/Clinical Supervisor 678-722-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 5279) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 8573) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |