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General NPI Number Information
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NPI Number | 1700289063
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Entity Type | Organization
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Legal Business Name | ATLANTA RELATIONSHIP INSTITUTE
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Dates
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Enumeration Date | 10/01/2014
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 365 NORTHRIDGE RD SUITE 310
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City | ATLANTA
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State | GA
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Zip | 30350-3207
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Country | US
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Telephone | 770-771-6903
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Fax |
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Provider Business Mailing Address
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Address Line | 365 NORTHRIDGE RD SUITE 310
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City | ATLANTA
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State | GA
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Zip | 30350-3207
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Country | US
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Telephone | 770-771-6903
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MS. MARILYN WITBECK
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Credential | LMFT, LPC
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Telephone | 404-713-8749
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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 | MFT001334
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC007904
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License Number State | GA
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