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General NPI Number Information
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NPI Number | 1669894879
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Entity Type | Organization
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Legal Business Name | YES.M
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Dates
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Enumeration Date | 01/08/2014
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 2605 BEN HILL RD
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City | EAST POINT
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State | GA
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Zip | 30344-1900
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Country | US
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Telephone | 770-716-3399
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Fax |
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Provider Business Mailing Address
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Address Line | 1572 HIGHWAY 85 N STE 211
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-7726
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Country | US
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Telephone | 770-716-3399
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DAMON A DAWSON
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Credential | MS
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Telephone | 404-426-4406
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC004599
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License Number State | GA
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