Organization
IAMIRONPANDA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON BUSSEY LPC, CLC, MB/TF-CBT (DIRECTOR)
(404) 594-0625
Entity
Organization
Contact information
Practice address
9 DUNWOODY PARK STE 136, DUNWOODY, GA 30338-6796
(404) 594-0625
Mailing address
2479 ORTEGA WAY, CHAMBLEE, GA 30341-3620
(404) 594-0625
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/11/2024
Last updated
03/11/2024
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