Organization
OMNI ONE PROFESSIONAL COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KNITIKIA GROSS (OWNER)
(678) 458-2150
Entity
Organization
Contact information
Practice address
436 EASTWYCK CIR, DECATUR, GA 30032-6694
(678) 458-2150
Mailing address
436 EASTWYCK CIR, DECATUR, GA 30032-6694
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
07/01/2022
Last updated
07/01/2022
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