NPI age
19 years
Enumerated 2007-01-22
Across 7547 active counselor providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (KS) | 100098080C | SED WAIVER |
| 05 (KS) | 100098080A |
Part of a multi-provider practice. 15 other active providers share this practice address in NPPES.
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