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General NPI Number Information
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NPI Number | 1326683491
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Entity Type | Organization
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Legal Business Name | INNER DEVELOPMENT LLC
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Dates
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Enumeration Date | 11/13/2019
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Last Update Date | 11/13/2019
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Provider Practice Location Address
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Address Line | 540 POWDER SPRINGS ST
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City | MARIETTA
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State | GA
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Zip | 30064-3549
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Country | US
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Telephone | 678-255-8444
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Fax | 678-402-5566
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Provider Business Mailing Address
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Address Line | 2023 RAMBLEWOOD CT
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City | MARIETTA
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State | GA
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Zip | 30062-3807
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Country | US
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Telephone | 770-540-5553
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | ANGELA SARAVIA
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Credential | LPC
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Telephone | 678-255-8444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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