Organization
OHM PSYCOTHERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. OPAL H MINOTT LCSW (LIC CLINICAL SOCIAL WRKR THERAPIST)
(770) 375-0479
Entity
Organization
Contact information
Practice address
3594 OLD CHAMBLEE TUCKER RD, ATLANTA, GA 30341
(770) 375-0479
(678) 985-4228
Mailing address
1083 SIMONTON HILL CT, LAWRENCEVILLE, GA 30045
(770) 375-0479
(678) 985-4228
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CSW003893
GA
1041C0700X
Clinical Social Worker
R0441101
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286447905A
—
GA
Enumeration date
12/24/2007
Last updated
12/24/2007
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