Organization
SMALLS THERAPEUTIC COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY NICOLE SMALLS MA (CHIEF EXECUTIVE OFFICER)
(404) 328-6685
Entity
Organization
Contact information
Practice address
1195 FAIRVIEW RD, STOCKBRIDGE, GA 30281-1144
(404) 328-6685
Mailing address
PO BOX 71, ELLENWOOD, GA 30294-0071
(404) 328-6685
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
03/07/2011
Last updated
03/07/2011
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