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General NPI Number Information
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NPI Number | 1568997294
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Entity Type | Organization
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Legal Business Name | UNIFY THERAPEUTICS & TRAINING CENTER LLC
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Dates
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Enumeration Date | 05/01/2017
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Last Update Date | 05/01/2017
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Provider Practice Location Address
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Address Line | 3900 CROWN RD SW SUITE 162251
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City | ATLANTA
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State | GA
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Zip | 30304-0001
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Country | US
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Telephone | 404-944-9340
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Fax |
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Provider Business Mailing Address
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Address Line | 100 HARTSFIELD CENTER PKWY
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City | ATLANTA
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State | GA
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Zip | 30354-1341
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Country | US
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Telephone | 404-944-9340
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/PROVIDER
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Name | MARY KELLER
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Credential |
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Telephone | 404-944-9340
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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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