Organization
OLIVE TREE THERAPY & WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MENYUAN JORDAN LCSW (OWNER/ PSYCHOTHERAPIST)
(678) 361-5369
Entity
Organization
Contact information
Practice address
107 ENTERPRISE PATH STE 300, HIRAM, GA 30141-2690
(678) 361-5369
Mailing address
107 ENTERPRISE PATH STE 300, HIRAM, GA 30141-2690
(678) 361-5369
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
Other
Enumeration date
02/28/2024
Last updated
04/23/2024
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