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General NPI Number Information
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NPI Number | 1104358993
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Entity Type | Organization
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Legal Business Name | HARBOR OF LOVE
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Dates
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Enumeration Date | 03/30/2017
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Last Update Date | 03/30/2017
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Provider Practice Location Address
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Address Line | 3950 FREY RD NW #216
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City | KENNESAW
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State | GA
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Zip | 30144-5419
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Country | US
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Telephone | 678-663-1827
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Fax |
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Provider Business Mailing Address
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Address Line | 245 POWERS FERRY RD.
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City | MARIETTA
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State | GA
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Zip | 30067
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Country | US
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Telephone | 678-663-1827
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Fax |
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Authorized Official
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Title or Position | LLC WELLNESS CARE
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Name | DR. FRAN SCOTT
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Credential |
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Telephone | 770-639-1033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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