Organization
FAMILY CENTER FOR MINDFULNESS AND RESILIENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA OVERDORFF (ADMINISTRATOR)
(404) 983-1766
Entity
Organization
Contact information
Practice address
848 HIRAM ACWORTH HWY, HIRAM, GA 30141-2286
(404) 769-3084
Mailing address
1444 WILTSHIRE CIR, POWDER SPRINGS, GA 30127-1364
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LPC006329
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003107804B
—
GA
01
—
1316246044
INDIVIDUAL NPI
GA
01
—
LPC006329
GA STATE LICENSE
GA
Enumeration date
01/02/2018
Last updated
01/02/2018
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