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General NPI Number Information
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NPI Number | 1316787922
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Entity Type | Organization
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Legal Business Name | THE UNALOME JOURNEY
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Dates
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Enumeration Date | 05/30/2024
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 2641 RIVERFRONT DR
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City | SNELLVILLE
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State | GA
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Zip | 30039-8563
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Country | US
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Telephone | 470-484-3296
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Fax |
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Provider Business Mailing Address
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Address Line | 2296 HENDERSON MILL RD NE STE 116
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City | ATLANTA
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State | GA
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Zip | 30345-2739
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Country | US
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Telephone | 470-484-3296
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | REGINA HARRIS
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Credential |
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Telephone | 470-484-3296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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