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General NPI Number Information
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NPI Number | 1710580899
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Entity Type | Organization
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Legal Business Name | REDIRECTING LIFE SERVICES COUNSELING CENTER
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/25/2020
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Provider Practice Location Address
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Address Line | 6595 ROSWELL RD STE G-4048
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City | ATLANTA
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State | GA
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Zip | 30328-3152
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Country | US
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Telephone | 470-310-0213
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Fax | 877-295-9982
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Provider Business Mailing Address
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Address Line | 310 PRESTMOOR PL SW
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City | ATLANTA
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State | GA
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Zip | 30331-7655
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Country | US
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Telephone | 470-310-0213
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ZOE JOHNSON
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Credential |
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Telephone | 470-310-0213
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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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