NPI 1073643482 · live from the CMS NPI Registry
A Growth Place, INC.
Marriage & Family Therapist in Stockbridge, GA. National Provider Identifier 1073643482, active.
NPI record
| NPI | 1073643482 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Marriage & Family Therapist 106H00000X |
| Practice location | 10 Wilson Rd, Suite 1, Stockbridge, GA 30281 |
| Practice phone | 770-506-9575 |
| Enumerated | March 6, 2007 |
| Last updated | November 30, 2011 |
| Authorized official | Gregory Samples, President |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Marriage & Family Therapist primary | 106H00000X | MFT000125 (GA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.