Organization
MODERN WELLNESS COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIA POOLE LCSW (LICENSE CLINICAL SOCIAL WORKER)
(470) 576-4129
Entity
Organization
Contact information
Practice address
5030 RIVERTHUR PL, PEACHTREE CORNERS, GA 30096-2930
(470) 576-4129
Mailing address
5030 RIVERTHUR PL, PEACHTREE CORNERS, GA 30096-2930
(470) 576-4129
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
02/03/2025
Last updated
02/03/2025
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